Correlation Between Mutations In KRAS,NRAS,PIK3CA,APC And TP 53 Genes In High And Low Rectal Cancer Tissues And Clinical Characteristics Of Patients

Objective(s): To explore the correlation between mutations in KRAS,NRAS,PIK3 CA,APC and TP 53 genes in high and low rectal cancer tissues and the clinical characteristics of rectal cancer patients.Methods: Tumor specimens from 110 rectal cancer patients who underwent radical surgery between June 2020 and December 2022 were selected.KRAS,NRAS,PIK3 CA,APC and TP 53 gene mutations were detected by high-throughput sequencing(NGS)in rectal cancer tissues,and analyze the correlation between gene mutations in high and low rectal cancer and the gender,age,smoking history,alcohol history,tumor location,tumor diameter,the degree of tumor differentiation,pathological type,T stage,N stage,M stage,ACJJ stage,presence of carcinoma nodule metastasis,vascular infiltration status,nerve infiltration status,preoperative CEA level and preoperative CA199 level.Results: 1.Mutation rates of the KRAS,NRAS,PIK3 CA,APC,and TP 53 genes in 110 rectal cancer patients were 52.7%,4.5%,13.6%,54.5% and 56.4%,respectively.Among them,the mutation rate of KRAS gene in female patients is higher than that of male patients,and the mutation rate of KRAS gene in patients with normal preoperative CA199 level is higher than that of patients with increased preoperative CA199 level(both P<0.05);The mutation rate of NRAS gene in patients with tumor diameter 5cm is higher than that of patients with tumor diameter <5cm(P<0.05);The mutation rate of PIK3 CA gene was higher in highly differentiated patients than in moderately and poorly differentiated patients(P<0.05);The APC and TP 53 gene mutations were not associated with the clinical characteristics of the patients(P>0.05).2.In 59 cases of high rectal cancer,the mutation rate of KRAS gene in patients without nerve infiltration was higher than patients with nerve infiltration,the mutation rate of KRAS gene in patients with normal preoperative CEA level was higher than patients with elevated preoperative CEA level,and the mutation rate of KRAS gene in patients with increased preoperative CA199 level was higher than patients with normal preoperative CA199 level(all P<0.05);The mutation rate of NRAS gene in patients with tumor diameter 5cm is higher than that of patients with tumor diameter <5cm(P<0.05);Mutations in PIK3 CA,APC and TP 53 genes were not associated with patient clinical characteristics(P>0.05).3.In 51 cases of low rectal cancer,the mutation rate of KRAS gene in female patients is higher than that of male patients(P<0.05);The mutation rate of APC gene in patients with smoking history is higher than that of patients with no smoking history,The mutation rate of APC gene was higher in highly differentiated patients than in moderately and poorly differentiated patients,and the mutation rat of APC gene in patients with no cancer nodules is higher than that of patients with cancer nodule metastasis(all P<0.05);The mutation rate of TP 53 gene is higher in patients with N2 metastasis than those with N0 and N1 metastasis,and the mutation rate of TP 53 gene is higher in patients with stage II than that in stage I,III and IV(all P<0.05);The NRAS and the PIK3 CA genes were not associated with the clinical characteristics of the patients(P>0.05).4.KRAS gene mutations are inversely correlated with NRAS gene mutations(P<0.05).KRAS and NRAS genes were not significantly correlated with PIK3 CA,APC and TP53 genes(P>0.05).APC gene mutations were positively correlated with PIK3 CA and TP53 gene mutations(P<0.05).Conclusion(s): 1.The ranking of gene mutations in rectal cancer tissues were TP 53,APC,KRAS,PIK3 CA and NRAS.2.Mutations in KRAS,NRAS,PIK3 CA,APC and TP 53 genes were associated with clinical features of patients with high and low rectal cancer.KRAS gene mutations were negatively correlated with NRAS gene mutations,and APC gene mutations were positively correlated with PIK3 CA and TP53 gene mutations.3.KRAS,NRAS,PIK3 CA,APC and TP 53 gene testing has certain guiding significance for the diagnosis and individualized precision diagnosis and treatment of rectal cancer.