C-met蛋白表达及KRAS，PIK3CA基因突变在结直肠癌原发灶和肝转移灶中的临床意义

发布时间：2018-05-18 01:14

  本文选题：结直肠癌 + KRAS　； 参考：《山西医科大学》2017年硕士论文

【摘要】：目的:检测结直肠癌(colorectal cancer,CRC)原发灶和相应肝转移灶癌组织中C-met蛋白表达情况及KRAS,PIK3CA基因突变状态,并分析其与CRC各个临床病理参数及预后的相关性。方法:1.对58例CRC原发灶及相应肝转移灶癌组织分别采用免疫组织化学法(IHC)检测C-met蛋白表达情况,分析其表达差异。2.采用实时荧光定量PCR方法(Real-time PCR)检测58例CRC患者原发灶和肝转移灶癌组织中KRAS,PIK3CA基因突变状态。结果:1.58例CRC原发灶和相应肝转移灶中C-met蛋白高表达率分别为74.14%(43/58),81.03%(47/58)。原发灶中C-met蛋白高表达与临床分期相关,转移灶中C-met蛋白高表达与原发灶大体分型相关,差异有统计学意义。2.58例CRC中,KRAS基因在原发灶和相应肝转灶中的突变率分别为31.03%(18/58)、25.86%(15/58),最常见的突变位点为G12D。PIK3CA基因在CRC原发灶和相应肝转灶中的突变率分别为8.62%(5/58)、10.34%(6/58),最常见的突变位点为E545K。仅有1例CRC同时发生KRAS、PIK3CA基因突变。3.KRAS,PIK3CA基因突变状态在结直肠癌原发灶及相应肝转移灶中的一致性较好(Kappa≥0.75)。4.KRAS突变状态与CRC原发肿瘤部位、转移灶数目、大体类型相关(P0.05),PIK3CA突变状态与同时性/异时性肝转移、转移灶数目等方面有统计学差异(P0.05)。5.同时性肝转移和KRAS突变是影响CRC预后的危险因素。结论:1.原发灶中C-met蛋白高表达与临床分期相关,转移灶中C-met蛋白高表达与原发灶大体分型相关。2.KRAS突变状态与CRC原发灶的肿瘤部位、转移灶多少、大体类型相关,PIK3CA突变状态与同时性/异时性肝转移、转移灶多少相关。3.原发灶和/或肝转移灶均可作为分子检测的组织来源。4.同时性肝转移和KRAS突变均与CRC预后不良相关。
[Abstract]:Objective: to detect the expression of C-met protein and the mutation status of KRAS-PIK3CA gene in primary and corresponding liver metastases of colorectal carcinoma, and to analyze its correlation with the clinicopathological parameters and prognosis of CRC. Method 1: 1. Immunohistochemical method was used to detect the expression of C-met protein in 58 cases of CRC primary tumor and corresponding liver metastases, and the difference of C-met protein expression was analyzed. 2. Real-time PCR was used to detect the mutation status of KRAS-PIK3CA gene in primary and metastatic cancer tissues of 58 patients with CRC. Results the high expression rate of C-met protein was 74.14% in primary tumor of CRC and 74.14% in corresponding liver metastases. The high expression of C-met protein was correlated with the clinical stage in the primary tumor, and the high expression of C-met protein in the metastatic tumor was correlated with the gross classification of the primary tumor. The difference was statistically significant. The mutation rate of KRAS gene in primary tumor and corresponding liver transition in CRC was 31. 03 / 58 and 25.86 / 58, respectively. The most common mutation locus was G12D.PIK3CA gene mutation in primary CRC and corresponding liver transition. The most common mutation site was E545K. There was only one case of CRC with KRAS-PIK3CA gene mutation. 3. The mutation status of KRAS-PIK3CA gene was consistent in the primary tumor of colorectal cancer and the corresponding liver metastases. The mutation status of Kappa 鈮，

本文编号：1903725