Abstract
BackgroundIdentifying the mutation status of KRAS is important for optimizing treatment in patients with colorectal cancer (CRC). The aim of this study was to investigate the predictive value of haematological parameters and serum tumour markers (STMs) for KRAS gene mutations.MethodsThe clinical data of patients with colorectal cancer from January 2014 to December 2018 were retrospectively collected, and the associations between KRAS mutations and other indicators were analysed. Receiver operating characteristic (ROC) curve analysis was performed to quantify the predictive value of these factors. Univariate and multivariate logistic regression models were applied to identify predictors of KRAS mutations by calculating the odds ratios (ORs) and their corresponding 95% confidence intervals (CIs).ResultsKRAS mutations were identified in 276 patients (35.2%). ROC analysis revealed that age, CA12–5, AFP, SCC, CA72–4, CA15–3, FERR, CYFRA21-1, MCHC, and tumor location could not predict KRAS mutations (P = 0.154, 0.177, 0.277, 0.350, 0.864, 0.941, 0.066, 0.279, 0.293, and 0.053 respectively), although CEA, CA19–9, NSE and haematological parameter values showed significant predictive value (P = 0.001, < 0.001, 0.043 and P = 0.003, < 0.001, 0.001, 0.031, 0.030, 0.016, 0.015, 0.019, and 0.006, respectively) but without large areas under the curve. Multivariate logistic regression analysis showed that CA19–9 was significantly associated with KRAS mutations and was the only independent predictor of KRAS positivity (P = 0.016).ConclusionsHaematological parameters and STMs were related to KRAS mutation status, and CA19–9 was an independent predictive factor for KRAS gene mutations. The combination of these clinical factors can improve the ability to identify KRAS mutations in CRC patients.
Highlights
Identifying the mutation status of KRAS is important for optimizing treatment in patients with colorectal cancer (CRC)
We aimed to investigate whether haematological parameters and serum tumour markers (STMs) could be used to predict the KRAS mutation status of CRC
Haematological parameters and STM measurements Haematological parameters were detected before detecting KRAS mutation status, and STMs were detected by a commercial chemiluminescence immunoassay kit (Abbott Laboratories, I4000, America)
Summary
Identifying the mutation status of KRAS is important for optimizing treatment in patients with colorectal cancer (CRC). Colorectal cancer (CRC) is one of the most common malignant diseases and is the third most common cancer and the third leading cause of mortality in America [1], and its incidence and mortality are ranked fifth in China [2] Despite advances in both prevention and treatment, metastatic colorectal cancer (mCRC) remains the second-leading cause of cancer-related mortality in the United States [3]. The remaining mutations mainly occur in codons 61 (5%) and 146 (5%) These mutations disable GTPase activity, causing tumour-associated KRAS to accumulate in the active GTP-bound conformation [5, 6]. There is an urgent need to develop a low-cost, simple and noninvasive detection method
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