结直肠癌组织与静脉血中KRAS基因突变分析及临床意义.docVIP

结直肠癌组织与静脉血中KRAS基因突变分析及临床意义 　　[摘要] 目的 研究结直肠癌组织与静脉血中KRAS基因突变情况，探讨其对临床治疗及预后的意义。 方法 整群收集2013年1月―2014年12月经病理科诊断手术的129例原发结直肠癌组织标本和肘静脉血5 mL及60例癌旁正常组织对照。用PCR-DNA直接测序法检测KRAS突变情况。 结果 ①癌组织KRAS突变率为39.53%（51/129），静脉血KRAS突变率为32.56 %（42/129）。静脉血KRAS基因突变率比癌组织的低6.97%，差异有统计学意义（P0.05）。癌旁正常组织无基因突变。②KRAS基因有7种突变类型， 12密码子为主要突变占78.43%（40/51）。③癌组织与静脉血野生型与突变型整体的一致率为89.92%（116/129），一致性较高（K=0.783）。 结论 结直肠癌组织KRAS基因突变与静脉血高度一致，在肿瘤组织无法获取的情况下能代替其作为检测靶点。 　　[关键词] 结直肠癌；KRAS基因；突变；静脉血 　　[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2016）02（a）-0051-03 　　Analysis and Clinical Significance of KRAS Mutations in the Colorectal Carcinoma and Venous Blood 　　WU Jie 　　Mudanjiang Second Peoples Hospital，157000 China 　　[Abstract] Objective To research the KRAS mutations in the colorectal carcinoma and venous blood and discuss the significance of it to the clinical treatment and prognosis. Methods 129 cases of primary colorectal carcinoma specimen receiving the diagnostic operation in the department of pathology from January 2013 to December 2014 and 5ml elbow vein blood were collected and 60 cases of adjacent normal tissues were collected as controls， KRAS mutations were detected by PCR-DNA direct sequencing method. Results 1.The KRAS mutation rate was 39.53%（51/129） in the cancer tissues and 32.56 %（42/129） in the venous blood， the KRAS mutation rate in the venous blood was 6.97% lower than that in the cancer tissues， the difference was statistically significant （P0.05）， and there was no mutation in adjacent normal tissues. 2.there were 7 types of mutations in the KRAS gene， 12 codons were the main mutation， accounting for 78.43%（40/51）. 3.the concordance rate between cancer tissues and venous blood of wild type and mutant type was 89.92%（116/129）， and it was higher （K=0.783）. Conclusion The KRAS mutation in the colorectal carcinoma is highly consistent with that in the venous blood， and it can be used as the detection target instead in the case of the tumor tissues unavailable. 　　[Key words] Colorectal cancer；