Nras、Braf、Kras、Pik3ca基因突变检测在大肠癌治疗和预后中的临床研究

Clinical Study on Detection of Nras, Braf, Kras and Pik3ca Gene Mutations in the Treatment and Prognosis of Colorectal Cancer

目的探讨大肠癌患者检测Nras、Braf、Kras、Pik3ca基因突变的临床价值。方法以2014年2月-2018年11月为时限,方便择取该院65例大肠癌患者,取术后新鲜肿瘤组织样本进行基因突变检测,观察其与大肠癌病理特征及生存率间的关系。结果结肠癌Braf突变率(11.11%)高于直肠癌,肿瘤直径3 cm以上患者Kras突变率(50.00%)高于3 cm以下患者,肿瘤低分化Braf突变率(21.05%)高于中高分化,肠癌复发Kras突变率(51.35%)高于未复发,差异有统计学意义(χ^2=3.715、7.651、6.843、5.680,P<0.05),Nras、Braf、Kras、Pik3ca基因突变患者3年生存率分别为0.00%、20.00%、67.86%、33.33%,均低于野生型基因,差异有统计学意义(χ^2=10.972、8.631、5.740、6.533,P<0.05)。结论 Nras、Braf、Kras、Pik3ca基因突变检测能够为大肠癌靶向治疗及预后评估提供有价值的依据和指导,值得推广使用。

Objective To investigate the clinical value of detecting Nras,Braf,Kras and Pik3ca gene mutations in patients with colorectal cancer.Methods From February 2014 to November 2018,convenient 65 patients with colorectal cancer were enrolled in our hospital.The fresh tumor tissue samples were taken for gene mutation detection to observe the relationship between pathological features and survival rate of colorectal cancer.Results The Braf mutation rate of colon cancer (11.11%) was higher than that of rectal cancer.The mutation rate of Kras mutation (50.00%) was higher than that of patients with tumor diameter above 3cm.The rate of poorly differentiated Braf mutation (21.05%) was higher than that of moderately differentiated colon cancer.The recurrent Kras mutation rate (51.35%) was higher than that without recurrence,the difference wasstatistically significant(χ^2=3.715、7.651、6.843、5.680,P<0.05).The 3-year survival rates of patients with Nras,Braf,Kras and Pik3ca mutations were 0.00%,20.00%,67.86%,33.33%,all lower than the wild type gene,the difference wasstatistically significant(χ^2=10.972、8.631、5.740、6.533,P<0.05).Conclusion The detection of Nras,Braf,Kras and Pik3ca gene mutations can provide valuable evidence and guidance for targeted therapy and prognosis evaluation of colorectal cancer.It is worthy of popularization.