背景:结直肠癌发病率的增加是世界范围内最常见的医学话题之一。它代表了全球男性和女性中第三大最常见的癌症,对公共卫生有重大影响。这种恶性肿瘤的死亡率仍然很高,仅次于肺癌.鉴于它们的临床相关性,对KRAS和BRAF突变的识别和理解已成为结直肠癌个体化治疗方法的重要组成部分.因此,我们的目标是开展一项研究,分析这些突变对被诊断为结直肠癌患者的生存率和死亡率的影响.
方法:我们在2018年至2022年期间进行了一项回顾性研究,纳入了118例诊断为结直肠癌的患者。患者是从Oradea县急诊临床医院和PelicanOradea医院的数据库中选择的。基因检测在“居民实验室”诊所进行。随后,根据突变的存在与否,将患者分为大小相等的两组.
结果:突变组结直肠癌诊断后一年的生存率为84.74%(N=50/59),野生型为67.96%(N=40/59)。野生型肿瘤患者在确诊结直肠癌后5年生存率为25.93%(N=15/59),而突变状态肿瘤患者为33.54%(N=20/59)(p=0.483,HR=1.153,CI95%0.7661-1.735)。五年生存率,根据存在的突变,KRAS突变患者的平均总生存期为38.6个月(CI95%35.22-41.97),BRAF突变患者的平均总生存期为8.3个月(CI95%5.42-11.17)(p=0.039).KRAS突变体的死亡率为44.89%(N=22/50),而对于那些有突变BRAF的人来说,它是100%(N=6/6)。
结论:我们观察到两个研究组之间的总生存率和无病间隔没有统计学上的显着差异,但存在突变的患者的总生存期更好(野生型肿瘤38.64个月vs31.07个月).在具有野生型状态的肿瘤中死亡率较高(p=0.005),在诊断结直肠癌后的第一年。BRAF突变的预后比KRAS突变差得多,从生存分析和死亡率来看。
BACKGROUND: The increasing incidence of colorectal cancer is one of the most frequently addressed medical topics worldwide. It represents the third most commonly diagnosed cancer in both men and women globally, with significant implications for public health. Mortality for this type of malignancy remains high, second only to lung cancer. Given their clinical relevance, the identification and understanding of KRAS and BRAF mutations have become crucial components of personalized medicine approaches in colorectal cancer. Hence, our desire is to carry out a research that analyzes the impact of these mutations in terms of survival and mortality on patients diagnosed with colorectal cancer.
METHODS: We conducted a retrospective study spanning from 2018 to 2022, which involved 118 patients diagnosed with colorectal cancer. The patients were selected from the databases of the Oradea County Emergency Clinical Hospital and Pelican Oradea Hospital. Genetic testing was performed at the \"Resident Laboratory\" clinic. Subsequently, patients were divided into two groups of equal size based on the presence or absence of mutations.
RESULTS: The survival rate one year after the diagnosis of colorectal cancer is 84.74% (N=50/59) for the mutant group versus 67.96% (N=40/59) for the wild-type group. The survival rate at five years from the diagnosis of colorectal cancer is 25.93% (N=15/59) for patients with wild-type tumors compared to 33.54% (N=20/59) for patients with tumors with mutant status (p=0.483, HR=1.153, CI 95% 0.7661-1.735). The five-year survival rate, depending on the mutation present, highlights the fact that the average overall survival for those with the KRAS mutation is 38.6 months (CI 95% 35.22-41.97) and for those with the BRAF mutation is 8.3 months (CI 95% 5.42-11.17) (p=0.039). The mortality rate for mutant KRAS is 44.89% (N=22/50), while for those with mutant BRAF, it is 100% (N=6/6).
CONCLUSIONS: We observed no statistically significant difference in overall survival rate and disease-free interval between the two studied groups, but the overall survival was better for those with mutations present (38.64 months versus 31.07 months for wild-type tumors). The mortality rate is higher among tumors with wild-type status (p=0.005), in the first year after the diagnosis of colorectal cancer. The BRAF mutation confers a much worse prognosis than the KRAS mutation, from both the survival analysis and the mortality rate.