Relationship Between KRAS Gene Mutation With Clinical Pathological Factors And Prognosis In Patient With Colorectal Cancer Liver Metastasis

Objective:To investigate the impact of KRAS mutation on the clinicopathological characteristics and prognosis of colorectal cancer liver metastasis(CRLM)patients.Methods:The clinical data of 283 patients with CRLM detected by KRAS gene in the Department of anorectal surgery of The Affiliated Hospital of Guizhou Medical University from January 2017 to November 2021 were analyzed retrospectively.The clinicopathological factors of KRAS gene mutation in CRLM patients were analyzed by means of X~2 test,univariate and multivariate logistic regression curve analysis.The survival condition was analyzed by univariate Kaplan-Meier method and intergroup test by log-rank method.COX regression model was used for multivariate survival analysis and risk assessment to analyze the correlation between KRAS gene mutation and clinicopathological features and prognosis of CRLM patients.Results:1.Among the 283 CRLM patients,163 were in the KRAS gene mutation group,and the KRAS gene mutation rate was 57.6 %.2.Single factor analysis showed that the mutation status of KRAS gene was related to the location of primary tumor(P = 0.005),the differentiation degree of primary tumor(P = 0.003),and the change of CA199(P = 0.030).Multivariate regression analysis showed that CA199 increased(OR = 2.136,95 % CI: 1.150-3.968,P = 0.016 < 0.05);the primary tumor was in the right colon(OR = 2.308,95 % CI:1.217-4.376,P = 0.010 < 0.05);good differentiation of primary tumor(OR = 2.271,95 % CI: 1.311 – 3.93,P = 0.003 < 0.05)was an independent influencing factor for KRAS gene mutation in CRLM patients.3.The results of the univariate survival analysis showed that KRAS mutation status was associated with the overall survival of CRLM patients.Kaplan-Meier and COX survival analysis showed that the mean survival time of CRLM patients with KRAS mutation was 21.9 months(95% CI 19.129-24.626)and 29.3 months(95% CI25.844-32.789)for wild-type and KRAS mutation,respectively.25.844-32.789);median survival time was 15 months(95% CI 12.918-17.082)and 23 months(95% CI16.394-29.606),P<0.05,respectively,with a statistically significant difference.Conclusions:1.KRAS gene mutation status of CRLM patients is closely related to the location of the primary tumor,CA199 level and the differentiation of the primary tumor.2.The long-term survival of CRLM patients with KRAS gene mutation is relatively poor.KRAS gene mutation is an independent factor for the prognosis of CRLM patients.