本文選題：結(jié)直腸癌 + KRAS�。� 參考：《山西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:檢測結(jié)直腸癌(colorectal cancer,CRC)原發(fā)灶和相應(yīng)肝轉(zhuǎn)移灶癌組織中C-met蛋白表達情況及KRAS,PIK3CA基因突變狀態(tài),并分析其與CRC各個臨床病理參數(shù)及預(yù)后的相關(guān)性。方法:1.對58例CRC原發(fā)灶及相應(yīng)肝轉(zhuǎn)移灶癌組織分別采用免疫組織化學(xué)法(IHC)檢測C-met蛋白表達情況,分析其表達差異。2.采用實時熒光定量PCR方法(Real-time PCR)檢測58例CRC患者原發(fā)灶和肝轉(zhuǎn)移灶癌組織中KRAS,PIK3CA基因突變狀態(tài)。結(jié)果:1.58例CRC原發(fā)灶和相應(yīng)肝轉(zhuǎn)移灶中C-met蛋白高表達率分別為74.14%(43/58),81.03%(47/58)。原發(fā)灶中C-met蛋白高表達與臨床分期相關(guān),轉(zhuǎn)移灶中C-met蛋白高表達與原發(fā)灶大體分型相關(guān),差異有統(tǒng)計學(xué)意義。2.58例CRC中,KRAS基因在原發(fā)灶和相應(yīng)肝轉(zhuǎn)灶中的突變率分別為31.03%(18/58)、25.86%(15/58),最常見的突變位點為G12D。PIK3CA基因在CRC原發(fā)灶和相應(yīng)肝轉(zhuǎn)灶中的突變率分別為8.62%(5/58)、10.34%(6/58),最常見的突變位點為E545K。僅有1例CRC同時發(fā)生KRAS、PIK3CA基因突變。3.KRAS,PIK3CA基因突變狀態(tài)在結(jié)直腸癌原發(fā)灶及相應(yīng)肝轉(zhuǎn)移灶中的一致性較好(Kappa≥0.75)。4.KRAS突變狀態(tài)與CRC原發(fā)腫瘤部位、轉(zhuǎn)移灶數(shù)目、大體類型相關(guān)(P0.05),PIK3CA突變狀態(tài)與同時性/異時性肝轉(zhuǎn)移、轉(zhuǎn)移灶數(shù)目等方面有統(tǒng)計學(xué)差異(P0.05)。5.同時性肝轉(zhuǎn)移和KRAS突變是影響CRC預(yù)后的危險因素。結(jié)論:1.原發(fā)灶中C-met蛋白高表達與臨床分期相關(guān),轉(zhuǎn)移灶中C-met蛋白高表達與原發(fā)灶大體分型相關(guān)。2.KRAS突變狀態(tài)與CRC原發(fā)灶的腫瘤部位、轉(zhuǎn)移灶多少、大體類型相關(guān),PIK3CA突變狀態(tài)與同時性/異時性肝轉(zhuǎn)移、轉(zhuǎn)移灶多少相關(guān)。3.原發(fā)灶和/或肝轉(zhuǎn)移灶均可作為分子檢測的組織來源。4.同時性肝轉(zhuǎn)移和KRAS突變均與CRC預(yù)后不良相關(guān)。
[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，

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