CAJ | 학술논문

目的：研究结直肠腺癌BRAF基因突变对临床治疗和预后的意义。方法整群收集该院2009年1-12月经病理科诊断手术的166例癌组织标本及61例癌旁正常组织。用PCR-DNA测序法测BRAF突变情况,对病理资料统计和随访60个月生存情况。结果①癌组织中BRAF突变率9.04%，常见类型BRAF-V600E，癌旁正常组织无突变。②癌组织分级低突变率较组织分级高的患者高，有淋巴转移突变率较无转移患者的高，差异有统计学意义(P<0.05)；与患者性别、年龄、发病部位、远处转移无相关性(P>0.05)。③癌组织为BRAF突变型的患者生存率较野生型的低，两条生存曲线明显分开差异有统计学意义(P<0.05)。结论结直肠癌患者中，癌组织BRAF基因突变率明显高于癌旁正常组织与分化程度、淋巴转移有相关性，与患者生存率成负相关提示预后不良。
목적：연구결직장선암BRAF기인돌변대림상치료화예후적의의。방법정군수집해원2009년1-12월경병이과진단수술적166례암조직표본급61례암방정상조직。용PCR-DNA측서법측BRAF돌변정황,대병리자료통계화수방60개월생존정황。결과①암조직중BRAF돌변솔9.04%，상견류형BRAF-V600E，암방정상조직무돌변。②암조직분급저돌변솔교조직분급고적환자고，유림파전이돌변솔교무전이환자적고，차이유통계학의의(P<0.05)；여환자성별、년령、발병부위、원처전이무상관성(P>0.05)。③암조직위BRAF돌변형적환자생존솔교야생형적저，량조생존곡선명현분개차이유통계학의의(P<0.05)。결론결직장암환자중，암조직BRAF기인돌변솔명현고우암방정상조직여분화정도、림파전이유상관성，여환자생존솔성부상관제시예후불량。
Objective To study the significance of BRAF genetic mutations for clinical treatment and prognosis of colorectal cancer patients. Methods 161 specimens of rectal adenocarcinoma and 61 normal tissues near the cancer from diagnose and surgery of the pathology department during January 2009 and December 2009 were selected. BRAF genetic mutations were detected by PCR-DNA sequencing. The pathological data was recorded and the follow-up of 60-months-survival rate was performed. Results 1. In the rectal adenocarcinoma, BRAF genetic mutations rate was 9.04% and BRAF-V600E was the most common type, and no mutations was found in the normal tissues near the cancer. 2. The mutations rate was higher in patients in lower histological grade than those in higher histological grade, in patients with lymphatic metastasis than those without lymphatic metastasis, and the differences were statistically significant (P<0.05); however, there were no correlation between mutations rate and gender, age, pathogenic sites, as well as distant metastasis(P>0.05). 3. The survival rates of patients with BRAF Mutation were lower than those with wild type BRAF, and the difference in survival curves was statistically significant(P<0.05). Conclusion In patients with colorectal cancer, the BRAF genetic mutations rate was higher in the rectal adenocarcinoma than in the tissues near the cancer, and it is closely related with histological grades and lymphatic metastasis but negatively correlated with the survival rate and heralds a poor prognosis.