Prognostic value of important driver gene mutations in patients with radical resection of pancreatic cancer
10.3760/cma.j.issn.0529-5815.2019.11.009
- VernacularTitle: 四种驱动基因突变状态对根治性切除胰腺癌患者预后的评估价值
- Author:
Jing SHEN
1
;
Suizhi GAO
2
;
Huan WANG
2
;
Xiaohan SHI
2
;
Bo LI
2
;
Yaqi PAN
2
;
Shuo SHEN
2
;
Zhuo SHAO
2
;
Shiwei GUO
2
;
Gang JIN
2
Author Information
1. Department of Hepato-Biliary-Pancreatic Surgery, Changhai Hospital, Navy Medical University, Shanghai 200433,China (Shen Jing is working at the Department of General Surgery,No. 971 Hospital of Navy,Qingdao 266071,China)
2. Department of Hepato-Biliary-Pancreatic Surgery, Changhai Hospital, Navy Medical University, Shanghai 200433,China
- Publication Type:Journal Article
- Keywords:
Pancreatic neoplasms;
Gene mutation;
Radical resection;
Prognosis;
Survival
- From:
Chinese Journal of Surgery
2019;57(11):840-847
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To examine the prognostic value of four important driver gene mutations in patients with radical resection of pancreatic cancer.
Methods:The clinical data and follow-up data of pancreatic cancer patients undergoing radical pancreatectomy and targeted sequencing from January 2016 to March 2018 at Department of Hepato-Biliary-Pancreatic Surgery, Changhai Hospital were retrospectively analyzed.There were 159 males and 88 females,aged of (60.8±8.7)years(range:33-83 years) and preoperative CA19-9 of (492.4±496.6)kU/L(range: 2-1 200 kU/L). One hundred and fifty nine cases of tumors were located in the head and 88 cases in the body and tail of the pancreas. After univariate analysis of clinical pathological factors (including gender, age, preoperative CA19-9, tumor location, tumor differentiation, pathological T and N stage, Micr. perineural invasion, Micr. lympho-vascular invasion, resection margin), the variable whose P<0.1 was included in COX regression model with four important driver gene mutations to find which mutation was related to prognosis independently. The number of gene mutations and KRAS subgroups were analyzed by Kaplan-Meier curve.
Results:Among 247 patients,the number of KRAS,TP53, SMAD4 and CDKN2A mutations was 212 cases(85.8%), 160 cases(64.8%), 66 cases(26.7%) and 44 cases(17.8%),respectively.KRAS mutation was correlated with the tumor differentiation and pathological T stage (χ2=24.570/6.690, P=0.000/0.035), TP53 mutation was correlated with the tumor differentiation and the resected margin(χ2=5.500/4.620, P=0.019/0.032), and CDKN2A mutation was correlated with gender(χ2=16.574, P=0.000).COX regression model analysis showed that only KRAS mutation was an independent risk factor for disease free survival and overall survival(HR=1.776, 95%CI: 1.079-2.923, P=0.024; HR=1.923, 95%CI: 1.016-3.639, P=0.045); KRASG12D mutation was associated with shorter OS(P=0.007).
Conclusion:KRAS and its subgroup KRASG12D mutation can be used as a prognostic index for patients with radical resection of pancreatic cancer.
