Histology and its prognostic effect on KRAS‑mutated colorectal carcinomas in Korea

Abstract

KRAS mutation is frequently identified in advanced colorectal carcinoma (CRC); however, its prognostic significance and the associated histological features have remained to be clarified. In the present study, the precise histological results and prognostic value of KRAS-mutated CRCs were investigated in patients from South Korea. A retrospective review of the results from KRAS mutation testing, as well as evaluation of the histology of 310 cases of CRC at various stages, were performed. Cross-tabulation and survival analysis were performed according to the KRAS status. Patients with KRAS mutation more frequently exhibited serrated and papillary architectures (P= 0.009 and P= 0.014, respectively). KRAS mutation was an independent unfavorable prognostic factor for overall survival (OS) according to multivariate analysis (P= 0.001), whereas no association was observed with disease-free survival (DFS) (P= 0.611). Of note, in the subgroup of KRAS-mutated carcinomas, the presence of a solid component on histology was associated with less favorable OS (P= 0.032). Furthermore, among the wild type cases, patients with a micropapillary component had a worse OS than those who did not (P=0.018). However, no subgroup or specific histological features were associated with DFS. In summary, KRAS-mutated CRCs had a moderate association with particular histological features, and according to the KRAS mutational status, there was a certain degree of association between histology and prognosis.

Correlation Between DCAMKL-1 Protein Expression and K-ras Gene Mutation in Colorectal Cancer

“…30 The results of several studies also showed that compared with that of CRC patients with the wild-type K-ras gene, the prognosis of patients with K-ras gene mutations was worse; the difference was statistically significant. [31][32][33] In this study, the survival rate for patients with K-ras mutations was significantly lower than that for patients with wild-type K-ras, a finding that is consistent with literature reports. However, some studies have also shown that K-ras gene mutations are not significantly correlated with the prognosis of CRC patients.…”

Cribriform-type adenocarcinoma of the colorectum: comprehensive molecular analyses of a distinctive histologic subtype of colorectal cancer

“…In addition, the prognostic role of KRAS mutations has been debated. Although a study including metastatic CRCs showed no association between KRAS mutations and disease-free survival (DFS), most studies, including those on non-metastatic CRC, concluded that KRAS mutations are associated with poor disease-free survival ( 20 ). Thus, KRAS mutations in cribriform-type adenocarcinoma may be associated with prognosis.…”

Cyclooxigenase-2 (COX-2) expression in colorectal cancer and the correlation with histopathological grading, depth of tumor invasion and regional lymph node metastasis

“…Research conducted by Berbecka et al stated that there was no correlation between COX-2 expression and histopathological grade and other prognostic markers, which could be due to the influence of other molecular markers such as KRAS, TP53, BCL2, VEGFR2 gene mutations (15). Another study by Lee et al said that there was a strong correlation between KRAS gene mutations and solid areas in the tumor which affected histopathological grading (16). The results of spearman correlation between COX-2 expression (scored 5,6,7) and depth of tumor invasion (T2 and T3) above obtained a spearman correlation coefficient value of 0.058 with a p value of 0.763 (p>0.05) that meaning no significant correlation.…”