Characteristics Of Gene Mutations In Patients With Liver Metastasis From Colorectal Cancer And Their Relationship With Clinicopathological Characteristics And Prognosis

Objective:To investigate the gene mutation,clinicopathologic characteristics and prognosis of colorectal cancer patients with liver metastasis and distant metastasis.Methods:From January 2019 to October 2021,58 patients with colorectal cancer were selected from the Department of Gastrointestinal and Colorectal Surgery of Sino-Japanese Friendship Hospital of Jilin University,including 28 patients with distant metastasis of colorectal cancer,17 patients with liver metastasis and 11 patients with other non-liver metastasis;There were 30 patients with colorectal cancer without distant metastasis.All patients had undergone surgical treatment and were confirmed by pathology after surgery,and the second-generation sequencing gene detection of tumor tissue samples was performed.SPSS23.0software was used to analyze the presence or absence of liver metastasis and distant metastasis through chi-square test in terms of gene mutation(9 genes found in previous studies that may be related to metastatic colorectal cancer and have a high mutation rate in this study),gender,age,family history of cancer,tumor location,tumor pathological classification and differentiation,TNM stage,and vascular nerve infiltration;SPSS23.0 software was used to discuss the prognostic factors through Kaplan-Meier univariate analysis,Log-rank test and Cox multivariate regression analysis.Results:1.There were no statistically significant differences in APC,BRAF,PTEN,EGFR,ERCC1,PIK3 CA,TP53,XRCC1 gene mutations,sex,age,T stage,family history of cancer,tumor location,tumor pathological classification and differentiation of colorectal cancer patients with or without liver metastasis(P>0.05).2.There were no statistically significant differences in KRAS,APC,BRAF,PTEN,EGFR,ERCC1,PIK3 CA gene mutations,sex,age,T stage,family history of cancer,tumor location,tumor pathological classification and differentiation degree of colorectal cancer patients with or without distant metastasis(P>0.05).3.KRAS gene mutation is associated with liver metastasis of colorectal cancer.4.The mutations of TP53 and XRCC1 genes were associated with the distant metastasis of colorectal cancer.The distant metastasis rate of TP53 gene mutation group(58.1%)and XRCC1 gene mutation group(59.5%)were significantly different(P<0.05).5.Regional lymph node metastasis was also closely related to liver metastasis and distant metastasis of colorectal cancer,and the difference was statistically significant.6.The vascular and nerve invasion of the tumor can also lead to liver metastasis and distant metastasis of colorectal cancer(P<0.05).7.Comprehensive univariate and multivariate analysis showed that the prognosis of colorectal cancer patients with liver metastasis was not related to BRAF,EGFR,XRCC1 gene mutations,sex,age,vascular invasion,nerve invasion,and family history;The prognosis of patients with liver metastatic colorectal cancer is related to APC,ERCC1,KRAS,PIK3 CA,PTEN,TP53 mutation genes,tumor location,tumor pathological classification and differentiation,T stage,N stage,etc.8.The prognosis of patients with distant metastasis of colorectal cancer was not related to APC and EGFR gene mutations,age and vascular invasion;The prognosis of patients with distant metastatic colorectal cancer is related to BRAF,ERCC1,KRAS,PIK3 CA,PTEN,TP53,XRCC1 mutation genes,sex,tumor location,tumor pathological classification and differentiation,nerve invasion,T stage,N stage,family history,etc.Conclusion:1.Liver metastasis of colorectal cancer is related to KRAS gene mutation.The higher the mutation rate,the more likely liver metastasis will occur;The distant metastasis of colorectal cancer is related to the mutations of TP53 and XRCC1 genes.The higher the mutation rate,the easier the distant metastasis will occur;2.Liver metastasis and distant metastasis of colorectal cancer are related to tumor N stage.The more lymph node metastasis,the higher the metastasis rate.Patients with vascular and nerve invasion are more likely to have liver and distant metastasis;3.The prognosis of colorectal cancer patients with liver metastasis is related to APC,ERCC1,KRAS,PIK3 CA,PTEN,TP53 gene mutations and tumor location,tumor pathological classification and differentiation,T stage,N stage;4.The prognosis of patients with distant metastatic colorectal cancer is related to KRAS,TP53,BRAF,PTEN,ERCC1,PIK3 CA,XRCC1 gene mutations,sex,tumor location,tumor pathological classification and differentiation,nerve invasion,T stage,N stage,family history.