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目的:应用实时荧光定量PCR方法探讨K-ras基因突变情况及其临床病理意义。方法:收集71例结直肠癌石蜡组织,使用实时荧光定量PCR法检测K-ras基因状态。结果:结直肠癌中K-ras基因突变率为35.22%(25/71),发现7种突变(Gly12Asp,Gly12Val,Gly12Cys,Gly12Ser,Gly12Ala,Gly12Arg和Gly13Asp),其中1例为Gly12Val和Gly12Arg双突变,其中56.00%(14/25)的突变发生在第十二密码子的第二位碱基,且最常见类型为Gly12Asp。K-ras基因突变率在男性组中低于女性组(χ2=7.904,P=0.005),在无淋巴结转移组中低于有淋巴结转移组(χ2=5.851,P=0.016),差异有统计学意义,但K-ras基因突变与其他临床病理参数(年龄、肿瘤位置、浸润深度、组织学类型及Dukes’分期)差异均无统计学意义(P>0.05)。结论:女性或有淋巴结转移结直肠癌患者K-ras基因突变多见,可作为筛查是否进行分子靶向治疗的重点人群。
Objective: To investigate the mutation of K-ras gene and its clinicopathological significance by real-time fluorescence quantitative PCR. Methods: Seventy-one paraffin-embedded tissues of colorectal cancer were collected. The K-ras gene status was detected by real-time fluorescence quantitative PCR. Results: Seven mutations (Gly12Asp, Gly12Val, Gly12Cys, Gly12Ser, Gly12Ala, Gly12Arg and Gly13Asp) were found in 35.22% (25/71) of the patients with colorectal cancer. One case was Gly12Val and Gly12Arg double mutations , Of which 56.00% (14/25) mutations occurred at the second base of the twelfth codon and the most common type was Gly12Asp. The mutation rate of K-ras gene in the male group was lower than that in the female group (χ2 = 7.904, P = 0.005), but lower in the group without lymph node metastasis than in the group with lymph node metastasis (χ2 = 5.851, P = 0.016) However, there was no significant difference between K-ras gene mutation and other clinicopathological parameters (age, tumor location, depth of invasion, histological type and Dukes’ staging) (P> 0.05). Conclusion: K-ras gene mutation is more common in women with or without lymph node metastasis and can be used as a key population for screening molecular targeted therapy.