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Habashy P, Lea V, Wilkinson K, Wang B, Wu XJ, Roberts TL, Ng W, Rutland T, Po JW, Becker T, Descallar J, Lee M, Mackenzie S, Gupta R, Cooper W, Lim S, Chua W, Lee CS. KRAS and BRAF Mutation Rates and Survival Outcomes in Colorectal Cancer in an Ethnically Diverse Patient Cohort. Int J Mol Sci 2023; 24:17509. [PMID: 38139338 PMCID: PMC10743527 DOI: 10.3390/ijms242417509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/13/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
KRAS and BRAF mutation rates in colorectal cancer (CRC) reported from various mono-ethnic studies vary amongst different ethnic groups. However, these differences in mutation rates may not be statistically significant or may be due to differences in environmental and/or laboratory factors across countries rather than racial genetic differences. Here, we compare the KRAS/BRAF mutation rates and survival outcomes in CRC between ethnic groups at a single institution. We also investigate the contributions of genetic, environmental, and laboratory factors to the variations in KRAS/BRAF mutation rates reported from different countries. Clinicopathological data from 453 ethnically diverse patients with CRC were retrospectively analyzed at Liverpool Hospital, NSW Australia (2014-2016). KRAS/BRAF mutations were detected using real-time PCR (Therascreen kits from Qiagen). Mismatch repair (MMR) status was determined using immunohistochemical staining. Four ethnic groups were analyzed: Caucasian, Middle Eastern, Asian, and South American. Overall survival data were available for 406 patients. There was no significant difference in KRAS mutation rates between Caucasians (41.1%), Middle Easterners (47.9%), Asians (44.8%), and South Americans (25%) (p = 0.34). BRAF mutation rates differed significantly between races (p = 0.025), with Caucasians having the highest rates (13.5%) and Middle Easterners the lowest (0%). A secondary analysis in which Caucasians were divided into three subgroups showed that ethnic grouping correlated significantly with KRAS mutation rate (p = 0.009), with central and eastern Europeans having the highest rates (58.3%). There were no significant differences in overall survival (OS) or disease-free survival (DFS) between the four races. The similarity in KRAS mutation rates across races raises the possibility that the differences in KRAS mutation rates reported from various countries may either not be statistically significant or may be due to environmental and/or laboratory factors rather than underlying racial genetic differences. In contrast, we verified that BRAF mutation rates differ significantly between races, suggesting racial genetic differences may be responsible for the discrepant BRAF mutation rates reported from different countries.
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Affiliation(s)
- Paul Habashy
- Discipline of Pathology, School of Medicine, Western Sydney University, Sydney, NSW 2560, Australia; (P.H.); (T.R.)
- Liverpool Clinical School, Western Sydney University, Sydney, NSW 2170, Australia; (T.L.R.); (T.B.)
| | - Vivienne Lea
- Discipline of Pathology, School of Medicine, Western Sydney University, Sydney, NSW 2560, Australia; (P.H.); (T.R.)
- Department of Anatomical Pathology, Liverpool Hospital, Sydney, NSW 2170, Australia
| | - Kate Wilkinson
- Department of Medical Oncology, Liverpool Hospital, Sydney, NSW 2170, Australia
| | - Bin Wang
- Discipline of Pathology, School of Medicine, Western Sydney University, Sydney, NSW 2560, Australia; (P.H.); (T.R.)
- Ingham Institute for Applied Medical Research, Liverpool Hospital, Sydney, NSW 2170, Australia
| | - Xiao-Juan Wu
- Department of Anatomical Pathology, Liverpool Hospital, Sydney, NSW 2170, Australia
| | - Tara Laurine Roberts
- Liverpool Clinical School, Western Sydney University, Sydney, NSW 2170, Australia; (T.L.R.); (T.B.)
- Ingham Institute for Applied Medical Research, Liverpool Hospital, Sydney, NSW 2170, Australia
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW 2170, Australia
| | - Weng Ng
- Liverpool Clinical School, Western Sydney University, Sydney, NSW 2170, Australia; (T.L.R.); (T.B.)
- Department of Medical Oncology, Liverpool Hospital, Sydney, NSW 2170, Australia
- Ingham Institute for Applied Medical Research, Liverpool Hospital, Sydney, NSW 2170, Australia
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW 2170, Australia
| | - Tristan Rutland
- Discipline of Pathology, School of Medicine, Western Sydney University, Sydney, NSW 2560, Australia; (P.H.); (T.R.)
- Liverpool Clinical School, Western Sydney University, Sydney, NSW 2170, Australia; (T.L.R.); (T.B.)
- Department of Anatomical Pathology, Liverpool Hospital, Sydney, NSW 2170, Australia
| | - Joseph William Po
- Ingham Institute for Applied Medical Research, Liverpool Hospital, Sydney, NSW 2170, Australia
- Surgical Innovations Unit, Department of Surgery, Westmead Hospital, Sydney, NSW 2140, Australia
| | - Therese Becker
- Liverpool Clinical School, Western Sydney University, Sydney, NSW 2170, Australia; (T.L.R.); (T.B.)
- Ingham Institute for Applied Medical Research, Liverpool Hospital, Sydney, NSW 2170, Australia
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW 2170, Australia
| | - Joseph Descallar
- Ingham Institute for Applied Medical Research, Liverpool Hospital, Sydney, NSW 2170, Australia
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW 2170, Australia
| | - Mark Lee
- Department of Radiation Oncology, Liverpool Hospital, Sydney, NSW 2170, Australia
| | - Scott Mackenzie
- Liverpool Clinical School, Western Sydney University, Sydney, NSW 2170, Australia; (T.L.R.); (T.B.)
- Department of Surgery, Liverpool Hospital, Sydney, NSW 2170, Australia
| | - Ruta Gupta
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
| | - Wendy Cooper
- Discipline of Pathology, School of Medicine, Western Sydney University, Sydney, NSW 2560, Australia; (P.H.); (T.R.)
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
- Sydney Medical School, University of Sydney, Sydney, NSW 2050, Australia
| | - Stephanie Lim
- Liverpool Clinical School, Western Sydney University, Sydney, NSW 2170, Australia; (T.L.R.); (T.B.)
- Ingham Institute for Applied Medical Research, Liverpool Hospital, Sydney, NSW 2170, Australia
- Department of Medical Oncology, Campbelltown Hospital, Sydney, NSW 2560, Australia
| | - Wei Chua
- Liverpool Clinical School, Western Sydney University, Sydney, NSW 2170, Australia; (T.L.R.); (T.B.)
- Department of Medical Oncology, Liverpool Hospital, Sydney, NSW 2170, Australia
- Ingham Institute for Applied Medical Research, Liverpool Hospital, Sydney, NSW 2170, Australia
| | - Cheok Soon Lee
- Discipline of Pathology, School of Medicine, Western Sydney University, Sydney, NSW 2560, Australia; (P.H.); (T.R.)
- Liverpool Clinical School, Western Sydney University, Sydney, NSW 2170, Australia; (T.L.R.); (T.B.)
- Department of Anatomical Pathology, Liverpool Hospital, Sydney, NSW 2170, Australia
- Ingham Institute for Applied Medical Research, Liverpool Hospital, Sydney, NSW 2170, Australia
- South Western Sydney Clinical School, University of New South Wales, Sydney, NSW 2170, Australia
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
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Heuvelings DJI, Wintjens AGWE, Moonen L, Engelen SME, de Hingh IHJT, Valkenburg-van Iersel LB, den Dulk M, Beckervordersandforth J, Thijssen SGM, Leunissen DJG, Stassen LPS, Keszthelyi D, Mujagic Z, Speel EJM, Bouvy ND. Predictive Genetic Biomarkers for the Development of Peritoneal Metastases in Colorectal Cancer. Int J Mol Sci 2023; 24:12830. [PMID: 37629011 PMCID: PMC10454220 DOI: 10.3390/ijms241612830] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/04/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
Metastatic colorectal cancer (CRC) is a common cause of cancer-related mortality, of which peritoneal metastases (PMs) have the worse outcome. Metastasis-specific markers may help predict the spread of tumor cells and select patients for preventive strategies. This exploratory pilot study aimed to gain more insight into genetic alterations in primary CRC tumors, which might be a predictive factor for the development of PM. Forty patients with T3 stage CRC were retrospectively divided in three groups: without metachronous metastases during 5-year follow-up (M0, n = 20), with metachronous liver metastases (LM, n = 10) and with metachronous PM (PM, n = 10). Patients with synchronous metastases were excluded. Primary formalin-fixed paraffin-embedded tumor samples were analyzed via comprehensive genome sequencing (TSO500 analysis) to identify DNA alterations and RNA fusion transcripts in 523 genes and 55 genes, respectively. Thirty-eight samples were included for final analysis. Four M0 tumors and one PM tumor were microsatellite instable. BRAF mutations were uniquely identified in three microsatellite-stable (MSS) PM tumors (37.5%, p = 0.010). RNA analysis showed an additional FAM198A-RAF1 fusion in one PM sample. BRAF p.V600E mutations were only present in PM patients with MSS tumors. Greater attention should be paid to BRAF-mutated tumors in relation to the development of metachronous PM.
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Affiliation(s)
- Danique J. I. Heuvelings
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of General Surgery, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Anne G. W. E. Wintjens
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of General Surgery, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Laura Moonen
- GROW School for Oncology and Reproduction, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Pathology, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Sanne M. E. Engelen
- Department of General Surgery, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Ignace H. J. T. de Hingh
- GROW School for Oncology and Reproduction, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of General Surgery, Catharina Ziekenhuis, 5623 EJ Eindhoven, The Netherlands
| | - Liselot B. Valkenburg-van Iersel
- GROW School for Oncology and Reproduction, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Internal Medicine, Division of Medical Oncology, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Marcel den Dulk
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of General Surgery, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
- Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany
| | - Jan Beckervordersandforth
- Department of Pathology, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Sharon G. M. Thijssen
- Department of Pathology, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Daphne J. G. Leunissen
- GROW School for Oncology and Reproduction, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Pathology, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Laurents P. S. Stassen
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of General Surgery, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Daniel Keszthelyi
- Division of Gastroenterology and Hepatology, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Zlatan Mujagic
- Division of Gastroenterology and Hepatology, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Ernst-Jan M. Speel
- GROW School for Oncology and Reproduction, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of Pathology, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands
| | - Nicole D. Bouvy
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229 ER Maastricht, The Netherlands
- GROW School for Oncology and Reproduction, Maastricht University, 6229 ER Maastricht, The Netherlands
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Heuvelings DJI, Wintjens AGWE, Luyten J, Wilmink GEWA, Moonen L, Speel EJM, de Hingh IHJT, Bouvy ND, Peeters A. DNA and RNA Alterations Associated with Colorectal Peritoneal Metastases: A Systematic Review. Cancers (Basel) 2023; 15:cancers15020549. [PMID: 36672497 PMCID: PMC9856984 DOI: 10.3390/cancers15020549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/04/2023] [Accepted: 01/08/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND As colorectal cancer (CRC) patients with peritoneal metastases (PM) have a poor prognosis, new treatment options are currently being investigated for CRC patients. Specific biomarkers in the primary tumor could serve as a prediction tool to estimate the risk of distant metastatic spread. This would help identify patients eligible for early treatment. AIM To give an overview of previously studied DNA and RNA alterations in the primary tumor correlated to colorectal PM and investigate which gene mutations should be further studied. METHODS A systematic review of all published studies reporting genomic analyses on the primary tissue of CRC tumors in relation to PM was undertaken according to PRISMA guidelines. RESULTS Overall, 32 studies with 18,906 patients were included. BRAF mutations were analyzed in 17 articles, of which 10 found a significant association with PM. For all other reported genes, no association with PM was found. Two analyses with broader cancer panels did not reveal any new biomarkers. CONCLUSION An association of specific biomarkers in the primary tumors of CRC patients with metastatic spread into peritoneum could not be proven. The role of BRAF mutations should be further investigated. In addition, studies searching for potential novel biomarkers are still required.
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Affiliation(s)
- Danique J. I. Heuvelings
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229 ER Maastricht, The Netherlands
- Correspondence:
| | - Anne G. W. E. Wintjens
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Julien Luyten
- Department of General Surgery, Maastricht University Medical Center (MUMC+), 6202 AZ Maastricht, The Netherlands
| | - Guus E. W. A. Wilmink
- Department of General Surgery, Maastricht University Medical Center (MUMC+), 6202 AZ Maastricht, The Netherlands
- Faculty of Science and Engineering, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Laura Moonen
- Department of Pathology, Maastricht University Medical Center (MUMC+), 6202 AZ Maastricht, The Netherlands
- GROW–School for Oncology and Reproduction, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Ernst-Jan M. Speel
- Department of Pathology, Maastricht University Medical Center (MUMC+), 6202 AZ Maastricht, The Netherlands
- GROW–School for Oncology and Reproduction, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Ignace H. J. T. de Hingh
- GROW–School for Oncology and Reproduction, Maastricht University, 6229 ER Maastricht, The Netherlands
- Department of General Surgery, Catharina Ziekenhuis, 5623 EJ Eindhoven, The Netherlands
| | - Nicole D. Bouvy
- Department of General Surgery, Maastricht University Medical Center (MUMC+), 6202 AZ Maastricht, The Netherlands
- GROW–School for Oncology and Reproduction, Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Andrea Peeters
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre (MUMC+), 6202 AZ Maastricht, The Netherlands
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Ozemir IA, Aydemir MA, Gapbarov A, Ekinci O, Alimoglu O. The Effect of the Mucinous Component Presence on the Clinical Outcomes of Colorectal Cancer. GALICIAN MEDICAL JOURNAL 2022. [DOI: 10.21802/gmj.2022.4.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background. The effect of colorectal cancer (CRC) histological subtypes on the prognosis is still a controversial issue. We aimed to compare clinical findings, histopathologic data, and survival outcomes in CRC patients with classical and mucinous subtypes.
Methods. Patients who were operated on for CRC between 2010 and 2017 were included in the study. Patients were classified into two groups according to the presence of a mucinous component: mucinous adenocarcinoma (MAC) - mucinous component > 50% and classical adenocarcinoma (CAC). Clinical and histopathologic findings, recurrence, metastasis, and survival rates were compared.
Results. Data of the 484 CRC patients were documented. Sixty-nine patients (14.3%) were in the MAC group and 415 (85.7%) patients were in the CAC group. The mean age of patients with MAC and CAC was 63.4 ± 13.5 and 68.5 ± 12.7 years, respectively (p = 0.002). Proximal colon localization was found in 30 (43.5%) MAC patients and 123 (29.6%) CAC patients (p = 0.029). The number of patients with metastatic lymph nodes was higher in the MAC group (58% vs. 41.2%, p = 0.03). Nevertheless, there was no significant difference between the CAC and MAC groups in terms of disease-free survival (63.1% vs. 69.6%, p = 0.37) and disease-related mortality (23.6% vs. 23.2%, p = 0.94) over the follow-up period. Multivariate analysis showed that the presence of perineural invasion, patient’s age, and disease stage were associated with mortality in CRC patients.
Conclusions. MACs occurred at a younger age than CACs and were more likely localized in the proximal colon as compared to CACs. Despite increased lymph node metastasis in MAC patients, no statistical significance was detected in overall survival or disease-free survival. Multivariate analysis revealed that age, perineural invasion, and disease stage were relevant to mortality in CRC patients.
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Hao M, Wang K, Ding Y, Li H, Liu Y, Ding L. Which patients are prone to suffer liver metastasis? A review of risk factors of metachronous liver metastasis of colorectal cancer. Eur J Med Res 2022; 27:130. [PMID: 35879739 PMCID: PMC9310475 DOI: 10.1186/s40001-022-00759-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 07/09/2022] [Indexed: 12/07/2022] Open
Abstract
Abstract
Background
In recent years, with the increasing incidence of colorectal cancer (CRC) and its high fatality rate, CRC has seized the attention of the world. And liver metastasis, as the main cause of death of CRC, has become the leading cause of treatment failure in CRC, especially metachronous liver metastasis, have caused patients who underwent bowel resection to experience multiple tortures.
Main body
Metachronous liver metastasis has severely affected the quality of life and prognosis of patients. Therefore, in this review, we discuss risk factors for metachronous liver metastasis of CRC, which is the premise for effective intervention for CRC patients who suffer metachronous liver metastasis after undergoing surgery, as well as the signaling pathways associated with CRC.
Conclusion
The occurrence of metachronous liver metastasis is closely related to histology-based prognostic biomarkers, serum-based biomarkers, tumor microenvironment, pre-metastatic niche, liquid biopsy and tissue-based biomarkers. Further research is required to explore the risk factors associated with liver metastasis of CRC.
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Zhang Y, Qin X, Luo R, Wang H, Wang H, Luo H. Risk Factors for Synchronous Peritoneal Metastases in Colorectal Cancer: A Systematic Review and Meta-Analysis. Front Oncol 2022; 12:885504. [PMID: 35795042 PMCID: PMC9251319 DOI: 10.3389/fonc.2022.885504] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background Early detection of synchronous colorectal peritoneal metastases (CPMs) is difficult due to the absence of typical symptoms and the low accuracy of imaging examinations. Increasing the knowledge of the risk factors for synchronous CPM may be essential for early diagnosis and improving their management. This study aimed to identify the risk factors for synchronous CPM. Method The study was registered at PROSPERO (CRD42020198548). The PubMed, Embase and Cochrane Library databases were searched for studies comparing the clinicopathological and molecular features between patients with or without synchronous CPM. The pooled data were assessed by a random-effects model. Results Twenty-five studies were included. A synchronous CPM was positively associated with female sex (OR 1.299; 1.118 to 1.509; P = 0.001), PROK1/PROKR2-positivity (OR 2.244; 1.031 to 4.884; P = 0.042), right-sided colon cancer (OR 2.468; 2.050 to 2.970; P < 0.001), poorly differentiated grade (OR 2.560; 1.537 to 4.265; P < 0.001), BRAF mutation (OR 2.586; 1.674 to 3.994; P < 0.001), mucinous adenocarcinoma (OR 3.565; 2.095 to 6.064; P < 0.001), signet-ring cell carcinoma (OR 4.480; 1.836 to 10.933; P = 0.001), N1-2 (OR 5.665; 3.628 to 8.848; P < 0.001), T4 (OR 12.331; 7.734 to 19.660; P < 0.001) and elevated serum CA19-9 (OR 12.868; 5.196 to 31.867; P < 0.001). Conclusions These evidence-based risk factors are indicators that could predict the presence of synchronous CPMs and can improve their management. Systematic Review Registration www.crd.york.ac.uk/prospero, identifier: CRD42020198548.
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Affiliation(s)
- Yuanxin Zhang
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiusen Qin
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Rui Luo
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hui Wang
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huaiming Wang
- Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Huaiming Wang, ; Hongzhi Luo,
| | - Hongzhi Luo
- Department of Tumor Surgery, Zhongshan City People’s Hospital, Zhongshan, China
- *Correspondence: Huaiming Wang, ; Hongzhi Luo,
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Eurboonyanun K, Lahoud RM, Kordbacheh H, Pourvaziri A, Promsorn J, Chadbunchachai P, O'Shea A, Atre ID, Harisinghani M. Imaging predictors of BRAF mutation in colorectal cancer. Abdom Radiol (NY) 2020; 45:2336-2344. [PMID: 32193591 DOI: 10.1007/s00261-020-02484-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Colorectal cancer (CRC) is one of the leading causes of cancer deaths and is associated with various genetic mutations. BRAF mutations, found in approximately 10% of all CRCs, are associated with negative predictive outcomes. The goal of this study was to assess the relationship between the imaging findings and BRAF statuses of CRC patients. MATERIALS AND METHODS The study population was colorectal cancer patients who underwent biopsy or surgery in a single institution from September 2004 to October 2018, and in whom the pathologic specimens were tested for BRAF mutation. The exclusion criteria were (1) patients without pre-operative cross-sectional imaging, and (2) patients whose tumors were invisible on imaging. Two hundred and eighty-three patients met the inclusion criteria. Among them, 128 were excluded, and a total of 155 patients were enrolled in the study. RESULTS BRAF mutations were significantly more common in female patients (p = 0.007). Patients with mutated BRAF were significantly older than those with wild-type BRAF (p = 0.001). BRAF-mutant tumors were predominant in right-sided colon (p = 0.001) with higher numbers of polypoid- or mass-like morphology (p = 0.019) and heterogeneous enhancement (p = 0.009). Compared to their wild-type counterparts, BRAF-mutated CRCs have a lower occurrence of non-peritoneal, and overall metastases (p = 0.013 and p = 0.004, respectively). Logistic regression analysis showed three significant factors for the prediction of BRAF mutations in CRC patients: right-sided location (p = 0.002), heterogeneous tumor enhancement (p = 0.039), and lack of non-peritoneal metastasis (p = 0.043). CONCLUSION By recognizing the specific imaging features of BRAF-mutant CRCs, it would be possible to identify a patient who has a higher risk of carrying BRAF mutation.
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Affiliation(s)
- Kulyada Eurboonyanun
- Abdominal Imaging Division, Radiology Department, Massachusetts General Hospital, Boston, USA.
- Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
| | - Rita Maria Lahoud
- Abdominal Imaging Division, Radiology Department, Massachusetts General Hospital, Boston, USA
| | - Hamed Kordbacheh
- Abdominal Imaging Division, Radiology Department, Massachusetts General Hospital, Boston, USA
| | - Ali Pourvaziri
- Abdominal Imaging Division, Radiology Department, Massachusetts General Hospital, Boston, USA
| | - Julaluck Promsorn
- Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Payia Chadbunchachai
- Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Aileen O'Shea
- Abdominal Imaging Division, Radiology Department, Massachusetts General Hospital, Boston, USA
| | - Isha D Atre
- Abdominal Imaging Division, Radiology Department, Massachusetts General Hospital, Boston, USA
| | - Mukesh Harisinghani
- Abdominal Imaging Division, Radiology Department, Massachusetts General Hospital, Boston, USA
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Wu JB, Sarmiento AL, Fiset PO, Lazaris A, Metrakos P, Petrillo S, Gao ZH. Histologic features and genomic alterations of primary colorectal adenocarcinoma predict growth patterns of liver metastasis. World J Gastroenterol 2019; 25:3408-3425. [PMID: 31341365 PMCID: PMC6639555 DOI: 10.3748/wjg.v25.i26.3408] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 06/05/2019] [Accepted: 06/08/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Different histological growth patterns (HGPs) of colorectal carcinoma (CRC) liver metastasis are associated with patients’ prognosis and response to antiangiogenic therapy. However, the relationship between HGPs of liver metastasis and clinicopathological and genomic characteristics of primary cancer has not been well established.
AIM To assess whether certain clinicopathological and genomic features of primary CRC could predict the HGPs of liver metastasis.
METHODS A total of 29 patients with paired resections of both primary CRC and liver metastasis were divided into two groups: A (15 cases with desmoplastic liver metastasis) and B (14 cases with replacement liver metastasis). Clinical information was obtained from patients’ charts. Mismatch repair proteins, BRAFV600E, and PD-L1 were evaluated by immunohistochemistry. Five cases were selected randomly from each group for whole exome sequencing (WES) analysis.
RESULTS In the primary tumor, expanding growth pattern, low tumor budding score (TBS), and Crohn’s disease-like response (CDR) were associated with desmoplastic liver metastasis and better overall survival, whereas infiltrating growth pattern alone of primary carcinoma could predict the replacement liver metastasis and worse overall survival (P < 0.05). On WES analysis, primary carcinoma with desmoplastic liver metastasis showed mutations in APC (4/5); TP53 (3/5); KRAS, PIK3CA, and FAT4 (2/5); BRCA-1, BRCA2, BRAF, and DNAH5 (1/5), whereas primary carcinoma with replacement liver metastasis showed mutations in APC and TP53 (3/5); KRAS, FAT4, DNH5, SMAD, ERBB2, ERBB3, LRP1, and SDK1 (1/5).
CONCLUSION The HGPs, TBS, and CDR of primary CRC as well as the presence of specific genetic mutations such as those in PIK3CA could be used to predict the HGPs of liver metastasis, response to therapy, and patients’ prognosis.
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Affiliation(s)
- Jing-Bo Wu
- Department of Pathology, The Fifth People’s Hospital, Fudan University, Shanghai 200240, China
| | - Ali Lopez Sarmiento
- Department of Pathology, McGill University and the Research Institute of McGill University Health Center, Montreal H4A 3J1, Quebec, Canada
| | - Pierre-Olivier Fiset
- Department of Pathology, McGill University and the Research Institute of McGill University Health Center, Montreal H4A 3J1, Quebec, Canada
| | - Anthula Lazaris
- Cancer Research Program, The Research Institute of McGill University Health Center, Montreal H4A 3J1, Quebec, Canada
| | - Peter Metrakos
- Cancer Research Program, The Research Institute of McGill University Health Center, Montreal H4A 3J1, Quebec, Canada
| | - Stephanie Petrillo
- Cancer Research Program, The Research Institute of McGill University Health Center, Montreal H4A 3J1, Quebec, Canada
| | - Zu-Hua Gao
- Department of Pathology, McGill University and the Research Institute of McGill University Health Center, Montreal H4A 3J1, Quebec, Canada
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