The BRAF V600E mutation is an independent prognostic factor for survival in stage II and stage III colon cancer patients
The BRAF V600E mutation is an independent prognostic factor for survival in stage II and stage III colon cancer patients
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DOI：
10.1093/annonc/mdq258
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发表时间：
2010-12-01
影响因子：
50.5
通讯作者：
van den Brule, A. J. C.
中科院分区：
文献类型：
--
作者：
Farina-Sarasqueta, A.;van Lijnschoten, G.;van den Brule, A. J. C.
患者和方法：II期结肠癌患者（n = 106）仅接受手术治疗，258例III期患者均接受5-氟尿嘧啶化疗。结果：老年（P < 0.001）、右侧（P = 0.018）、高分化（P = 0.003）和MSI（P <0.001）患者在II期的发生率明显高于III期患者。在两组中，BRAF突变与MSI（P = 0.001）和BRAF突变与右侧肿瘤（P = 0.001）之间呈正相关。BRAF和KRAS的突变是相互排斥的。在合并II期和III期数据的多变量生存分析中，BRAF突变是总生存期（OS）和癌症特异性生存期的独立预后因素[OS的风险比（HR）= 0.45，95%置信区间（CI）0.25-0.8，HR = 0.47，95% CI 0.22-0.99]。结论：V600 E BRAF突变对II期和III期结肠癌患者预后不良，与疾病分期和治疗无关。
Patients and methods: Stage II colon carcinoma patients (n = 106) treated with surgery only and 258 stage III patients all adjuvantly treated with 5-fluorouracil chemotherapy were included. KRAS mutations in codons 12 and 13, V600E BRAF mutation and MSI status were determined.Results: Older patients (P < 0.001), right-sided (P = 0.018), better differentiated (P = 0.003) and MSI tumors (P < 0.001) were significantly more frequent in stage II than stage III. In both groups, there was a positive association between mutated BRAF and MSI (P = 0.001) and BRAF mutation and right-sided tumors (P = 0.001). Mutations in BRAF and KRAS were mutually exclusive. In a multivariate survival analysis with pooled stage II and stage III data, BRAF mutation was an independent prognostic factor for overall survival (OS) and cancer-specific survival [hazards ratio (HR) = 0.45, 95% confidence interval (CI) 0.25-0.8 for OS and HR = 0.47, 95% CI 0.22-0.99]. KRAS mutation conferred a poorer disease-free survival (HR = 0.6, 95% CI 0.38-0.97).Conclusions: The V600E BRAF mutation confers a worse prognosis to stage II and stage III colon cancer patients independently of disease stage and therapy.