The Prognostic Value of 18F-FDG PET/CT and KRAS Mutation in Colorectal Cancers
The Prognostic Value of 18F-FDG PET/CT and KRAS Mutation in Colorectal Cancers
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DOI：
10.4274/mirt.galenos.2019.33866
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发表时间：
2020-02-01
影响因子：
0.9
通讯作者：
Cermik, Tevfik Fikret
中科院分区：
文献类型：
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作者：
Arslan, Esra;Aksoy, Tamer;Cermik, Tevfik Fikret
目的：KRAS突变和肿瘤侧别对结直肠癌预后的影响是一个极具争议的课题。因此，我们评估之间的关联F-18-氟-2-脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-18-FDG PET/CT）成像的FDG摄取模式和KRAS突变和肿瘤定位诊断为结肠癌患者，并评估这三个因素对预后和生存率的影响。进行F-18-FDG PET/CT检查以进行治疗前分期。比较两组患者的原发肿瘤最大标准化摄取值（SUVmax）和生存数据。通过从石蜡包埋的肿瘤组织块中提取的基因组DNA，借助于实时聚合酶链反应技术检测KRAS突变。结果：25例患者为女性，58例为男性。患者的平均年龄为59.8 ± 11.3岁。平均随访时间为35.5 ± 18.9个月。83.1%的患者原发肿瘤位于左半结肠，16.9%位于右半结肠。在54.2%（n=45）的患者中检测到KRAS突变。原发性肿瘤患者的平均SUVmax估计为21.1 ± 9.1（范围= 6.0-47.5）。发现具有KRAS突变的患者的平均肿瘤SUVmax（24.0 +/- 9.0）显著高于没有KRAS突变的患者（17.7 +/- 8.2）（p=0.001）。有局部淋巴结转移的患者的平均生存期显著短于无局部淋巴结转移的患者，有远处淋巴结转移的患者的平均生存期显著短于无远处淋巴结转移的患者，在初始PET/CT中有器官转移的患者的平均生存期显著短于无器官转移的患者。此外，肿瘤位于左结肠（34.2 +/- 19.4）的患者的平均生存期几乎显著短于右结肠（43.2 +/- 14.6）（p=0.059）。结论：在我们的研究中，我们发现肿瘤定位对结肠癌患者的预后没有显著影响。另一方面，在KRAS突变的存在下观察到FDG摄取更高，并且得出结论，KRAS突变与更高的SUVmax共存是一个负面的预后因素。
Objective: Prognostic effect of KRAS mutation and side of tumor in colorectal cancer is a highly controversial subject. Therefore, we evaluated the association between FDG uptake pattern in F-18-fluoro-2-deoxy-glucose positron emission tomography/computed tomography (F-18-FDG PET/CT) imaging and KRAS mutation and tumor localization in patients with a diagnosis of colon cancer and assessed the effects of these three factors on prognosis and survival.Methods: Eighty-three patients with colorectal cancer were retrospectively induded in this study. F-18-FDG PET/CT study was performed for pretreatment staging. The maximum standardized uptake value (SUVmax) of the primary tumor and survival data of patients were compared between groups. KRAS mutations were detected with the help of real-time Polymerase Chain Reaction technique through genomic DNA extracted from paraffin-embedded tumor tissue blocks. Tumor lesions with potential KRAS mutations were classified as mutant KRAS and wild type.Results: Twenty five patients were female while 58 were male. The mean age of the patients was 59.8 +/- 11.3 years. Mean follow-up was 35.5 +/- 18.9 months. Primary tumor was localized in the left colon in 83.1% of patients and in the right colon in 16.9%. KRAS mutation was detected in 54.2% (n=45) of patients. Mean SUVmax of patients with primary tumor was estimated to be 21.1+9.1 (range= 6.0-47.5). Mean tumor SUVmax of patients with a KRAS mutation (24.0 +/- 9.0) was found to be significantly higher than those without KRAS mutation (17.7 +/- 8.2) (p=0.001). Mean survival was significantly shorter in patients with locoregional nodal metastasis than in patients without locoregional nodal metastasis as well as in patients with distant nodal metastasis than in patients without distant nodal metastasis and in patients with organ metastasis in initial PET/CT than in patients without organ metastasis. Also, mean survival was nearly statistically-significantly shorter in patients with tumors located in left colon (34.2 +/- 19.4) than in right colon (43.2 +/- 14.6) (p=0.059). However, we found no significant impact of KRAS mutation on survival.Conclusion: In our study, we found that tumor localization had no significant effect on prognosis in patients with colon cancer. On the other hand, FDG uptake was observed to be higher in the presence of KRAS mutation and it was concluded that coexistence of KRAS mutation with higher SUVmax is a negative prognostic factor.