|Table of Contents|

Relationship between K-Ras,BRAF,PIK3CA gene mutation and the efficacy and prognosis of neoadjuvant chemoradiotherapy for rectal cancer

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2023 16
Page:
3051-3055
Research Field:
Publishing date:

Info

Title:
Relationship between K-Ras,BRAF,PIK3CA gene mutation and the efficacy and prognosis of neoadjuvant chemoradiotherapy for rectal cancer
Author(s):
ZHANG Xinyuan1; FU Yongfeng2; BAI Lili1; YANG Sen1; MAO Yu1; DONG Lixin1
1.Department of Oncology;2.Department of Plastic Surgery,the First Hospital of Qinhuangdao,Hebei Qinhuangdao 066000,China.
Keywords:
rectal cancer; neoadjuvant chemoradiotherapy; K-Ras; BRAF; PIK3CA; gene mutation; evaluation of curative effect; prognosis
PACS:
R735.3+7
DOI:
10.3969/j.issn.1672-4992.2023.16.020
Abstract:
Objective:To investigate the relationship between K-Ras,BRAF,PIK3CA gene mutations and the efficacy and prognosis of neoadjuvant chemoradiotherapy (nCRT) for rectal cancer.Methods:From March 2015 to March 2020,182 rectal cancer patients who underwent nCRT and radical surgery in the hospital were selected as the research object.All patients received capecitabine chemotherapy before operation and long-term fractionated radiotherapy for 5 weeks.At 5~12 weeks after the end of nCRT,surgery was performed according to the tumor location and nCRT condition.After discharge,1-year follow-up was conducted.Tumor regression grade (TRG) was used to evaluate the efficacy of nCRT for rectal cancer.TRG grade 1-3 was included in the nCRT effective group,and TRG grade 4-5 was included in the nCRT ineffective group.Tumor tissues were taken by colonoscopy before nCRT,and the mutation status of K-Ras,BRAF and PIK3CA genes was detected.The relationship between K-Ras,BRAF and PIK3CA gene mutation and the curative effect and prognosis of rectal cancer nCRT was analyzed.Results:In 182 patients with rectal cancer,the mutation rates of K-Ras,BRAF and PIK3CA genes were 34.07%,6.59% and 13.19% respectively,and the effective rate of nCRT was 60.44%.The mutation rates of K-Ras,BRAF and PIK3CA genes in nCRT effective group were significantly lower than those in nCRT ineffective group (P＜0.05).The sensitivity,specificity and AUC of K-Ras,BRAF and PIK3CA gene mutation in predicting the curative effect of nCRT in rectal cancer were 68.45%,65.38%,57.76% and 72.39%,69.23%,63.12% and 0.626,0.573,0.532,respectively.Logistic regression analysis showed that K-Ras,BRAF,PIK3CA gene mutations were significantly correlated with nCRT efficacy in rectal cancer (P＜0.05).The average survival time of patients with K-Ras,BRAF and PIK3CA gene mutations was shorter than those without K-Ras,BRAF and PIK3CA mutations,respectively,and the difference was statistically significant (P＜0.05).Multivariate COX regression analysis showed that the death risk of patients with K-Ras,BRAF and PIK3CA gene mutations was 1.639 times,1.811 times and 1.432 times higher than that of those without K-Ras,BRAF and PIK3CA mutations,respectively (P＜0.05).Conclusion:K-Ras,BRAF,PIK3CA gene mutations are related to the efficacy and prognosis of nCRT in rectal cancer patients,and can be used as predictive indicators of nCRT efficacy and prognosis.

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Memo:
河北省秦皇岛市科学技术研究与发展计划项目（编号：202004A049）
Last Update: 1900-01-01