Relationship between KRAS and NRAS factors with clinicopathologic findings in patients with metastatic colon cancer

Abstract

Introduction: Colorectal cancer (CRC) is the third common cancer among human and the fourth common reason of mortalities caused by cancers around the world. During recent years, EGFR-related molecular pathways are known as an important therapeutic pathway. High frequency of mutations of RAS family such as KRAS and NRAS and their rapid incidence in colon cancer indicates their high potential as a biomarker for early detection.

Materials and Methods: In this cross sectional retrograde study, patients with colorectal cancer referring to Golestan Razi and Poursina Hospitals in Iran were evaluated during years 2009-2018. The rates of KRAS and NRAS factors were evaluated on paraffinized pathology samples of patients with metastatic colon cancer. Then, the correlation between mutation in these two factors with other clinicopathological findings of patients such as age, gender, tumor grade, location of primary lesion, time to progression (TTP), family history and presence or absence of lymphovascular invasion was investigated.

Results: There was no significant correlation observed between occurrence of NRAS and KRAS with age group, family history and gender in the present study. But there was a significant statistical correlation between the rate of NRAS gene incidence with location of primary lesion and tumor grade. Finally, there was found a significant correlation between both KRAS and NRAS genes with TTP, so that TTP of patients reported less than patients without mutations in both groups.

Conclusion: The present study showed that presence of both mutations in KRAS and NRAS makes the prognosis of disease worth such a way the location of primary lesion and tumor grade are two effective factors in incidence of NRAS gene and lymphovascular invasion is the effective factor on KRAS gene incidence. also, TTP is lower among patients with mutations in both KRAS and NRAS genes.