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目的:观察结直肠癌肝转移的原发灶和对应肝转移灶中K-ras基因的突变情况,比较两者的一致性。方法:从75例结直肠癌肝转移患者的原发灶和对应肝转移灶病理标本中提取肿瘤组织DNA,经聚合酶链反应(PCR)扩增K-ras基因,采用DNA直接测序法检测K-ras基因的突变情况。结果:有3例因DNA提取质量较差出组。72例中,有24例(33.3%)结直肠癌原发组织中K-ras基因为突变型;23例(31.9%)肝转移灶癌组织中K-ras基因为突变型。24例原发灶K-ras基因为突变型者中,有21例(87.5%)对应的肝转移灶K-ras基因为突变型;46例两者均为野生型。原发灶及对应肝转移灶两者的一致率为93.1%。两者不一致的情况有5例(6.9%)。结论:结直肠癌肝转移的原发灶和对应肝转移灶中K-ras基因的突变情况较为一致,可作为选用分子靶向药物的依据。
OBJECTIVE: To observe the mutation of K-ras gene in primary hepatic metastasis of colorectal cancer and corresponding hepatic metastasis, and to compare the consistency of the two. Methods: The DNA of tumor tissue was extracted from the primary tumor of liver metastasis of 75 patients with colorectal carcinoma and the corresponding pathological specimen of liver metastasis. The K-ras gene was amplified by polymerase chain reaction (PCR), and the direct sequencing of K -ras gene mutations. Results: There were 3 cases of poor quality extracted DNA out of the group. In 72 cases, K-ras gene was found to be mutated in 24 cases (33.3%) of primary colorectal cancer tissues and 23 cases (31.9%) of liver metastases were K-ras mutated. Of the 24 patients with K-ras gene mutations in the primary tumor, 21 (87.5%) had K-ras gene mutations in the liver metastases; 46 were both wild type. The agreement rate of primary tumor and corresponding liver metastasis was 93.1%. The two cases of inconsistency in 5 cases (6.9%). Conclusion: The mutation of K-ras gene in primary liver cancer and corresponding liver metastasis of colorectal cancer is more consistent, which can be used as the basis of selection of molecular targeted drugs.