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目的:探讨结直肠癌患者K-ras基因突变特点,并分析K-ras基因突变与结肠癌临床病理特征的相关性及其临床意义。方法:收集哈尔滨医科大学附属第一医院收治的500例结直肠癌患者的手术石蜡标本,采用突变扩增阻滞系统技术(amplification refractory mutation system,ARMS)检测K-ras基因第二外显子第12、13密码子的七种热点突变情况,分析其与结肠癌患者临床病理特征的相关性。结果:ARMS法检出K-ras基因突变213例,突变率为42.6%。K-ras基因突变与患者的年龄、性别、肿瘤发生的部位、肿瘤分化程度及有无淋巴结转移均无相关性(P>0.05),而与肿瘤的组织学类型具有相关性(P<0.05)。结论:(1)结直肠癌患者K-ras基因突变率较高,其中GLY12ASP位点突变率最高,GLY12ARG为稀有突变位点。(2)K-ras基因突变与结肠癌的组织学类型相关,可能用于结直肠癌患者治疗方案的选择。
Objective: To investigate the characteristics of K-ras gene mutation in patients with colorectal cancer and to analyze the correlation between the K-ras gene mutation and clinicopathological features of colon cancer and its clinical significance. Methods: The surgical paraffin specimens of 500 patients with colorectal cancer who were admitted to the First Affiliated Hospital of Harbin Medical University were collected. The amplification exon 2 12,13 codons of seven hot spot mutation situation, analyze its correlation with clinicopathological features of patients with colon cancer. Results: 213 cases of K-ras gene mutation were detected by ARMS, the mutation rate was 42.6%. There was no correlation between K-ras gene mutation and age, sex, location of tumor, tumor differentiation and lymph node metastasis (P> 0.05), but correlated with the histological type of tumor (P <0.05) . Conclusions: (1) The mutation rate of K-ras gene in patients with colorectal cancer is high, of which GLY12ASP locus has the highest mutation rate and GLY12ARG is a rare mutation locus. (2) The mutation of K-ras gene is related to the histological type of colon cancer, which may be used in the treatment of colorectal cancer patients.