Establishment Of A Novel Prognostic Heterogeneity Scoring System For KRAS Mutations And Its Clinical Significance In Patients With Metastatic Colorectal Cancer

Objective: To establish a new prognostic scoring system and to investigate the heterogeneity of KRAS mutation in patients with metastatic colorectal cancer.Methods: Through the retrospective analysis method,which collected from August 1,2017 to April 30,2019 the Fourth hospital of Hebei Medical University stay in the hospital after histopathological diagnosis of 1700 cases of colorectal cancer in patients with vascular tumors of sex,age,stage,parts and bolts and nerve invasion,lymph node metastasis,tumor size,tumor infiltration depth,transfer area,state of KRAS mutations and disease-free survival,clinical characteristics,such as establishing a database,select data of 52 patients with KRAS mutations were complete,these patients only KRAS testing,no other genetic testing.SPSS 21.0 was used to analyze the data,screen the risk factors that may affect the early postoperative recurrence and metastasis of colorectal cancer,and establish the prognostic scoring system.Kaplan-meie method was used to draw the survival curve,and log-rank test was conducted.COX method was used for univariate survival analysis.P<0.05 was considered statistically significant.Results: 1.Relationship between disease-free survival and clinical factors: there was no significant difference between DFS and gender,age,stage and lymph node metastasis(P>0.05);There were significant differences between the two groups(P<0.05).2.Univariate analysis was conducted for COX model: whether there were vascular tumor thromboembolus or nerve invasion,grade,invasion depth and site of metastasis were independent prognostic factors affecting colorectal cancer patients(P<0.05).3,Choose application may affect the prognosis of colorectal cancer screening in this paper four clinical factors,formulate prognostic score standards,set up a simplified scoring system(Based only on clinicopathological covariates,not including laboratory values),divided into low risk group(0～2.7)and high risk group(2.8～5.1)in the two groups,patients were 55.8%,44.2%,the median DFS 15 months,9 months,respectively.Conclusions: The establishment of a simple postoperative prognosis score system for patients with KRAS mutation can accurately guide the treatment plan and follow-up plan of patients in the high-risk group.