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Zekri J, Al-Shehri A, Mahrous M, Al-Rehaily S, Darwish T, Bassi S, El Taani H, Al Zahrani A, Elsamany S, Al-Maghrabi J, Sadiq BB. Mutations in codons 12 and 13 of K-ras exon 2 in colorectal tumors of Saudi Arabian patients: frequency, clincopathological associations, and clinical outcomes. Genet Mol Res 2017; 16:gmr-16-01-gmr.16019369. [PMID: 28218784 DOI: 10.4238/gmr16019369] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Mutations in codons 12/13 of K-ras exon 2 are associated with reduced benefit from anti-epidermal growth factor receptor antibody treatment for metastatic colorectal cancer (CRC). Here, we evaluated the frequency of K-ras mutations and their relationship with clinicopathological features and treatment outcomes in Saudi Arabian patients with CRC. The genetic status of K-ras was determined in 300 patients diagnosed with CRC. Clinical information was collected retrospectively. K-ras was wild-type in 58% and mutated in 42% of the tumors. Most mutations were at codon 12 (89%) and were associated with metastasis [odds ratio (OR) = 1.38 (95%CI = 1.14-1.67] and occurrence of >40 µg/L carcinoembryonic antigen (CEA) [OR = 1.33 (1.1-1.74)] during diagnosis. Patients in stages I-III of the disease with wild-type K-ras tumors had a median relapse free survival (RFS) of 29 months in contrast to 22 months for those with the mutated K-ras tumor (P = 0.0357). In multivariate analysis, only the stage of the disease significantly predicted RFS (P = 0.001). Patients in stage IV of CRC with the wild-type K-ras tumor did not reach the median overall survival (OS), whereas patients with the mutated K-ras tumor survived for 23.5 months (P = 0.044). CEA level >40 µg/L (P = 0.004) and status of K-ras (P = 0.044) were independent predictors of OS. This is the largest study investigating K-ras mutations in patients with CRC in the Middle East. Mutations were associated with advanced stage of CRC, higher serum CEA, shorter RFS and OS.
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Affiliation(s)
- J Zekri
- King Faisal Specialist Hospital Research Centre, Oncology, Jeddah, Saudi Arabia .,College of Medicine, Al-Faisal University, Saudi Arabia
| | - A Al-Shehri
- National Guard Hospital, Oncology, Jeddah, Saudi Arabia
| | - M Mahrous
- King Fahad Hospital, Oncology, Madinah, Saudi Arabia
| | - S Al-Rehaily
- National Guard Hospital, Oncology, Jeddah, Saudi Arabia
| | - T Darwish
- King Abdullah Medical City and Oncology Center, Oncology, Jeddah, Saudi Arabia
| | - S Bassi
- King Faisal Specialist Hospital Research Centre, Oncology, Jeddah, Saudi Arabia
| | - H El Taani
- King Abdullah Medical City, Oncology, Mekkah, Saudi Arabia
| | - A Al Zahrani
- King Abdullah Medical City, Oncology, Mekkah, Saudi Arabia
| | - S Elsamany
- King Abdullah Medical City, Oncology, Mekkah, Saudi Arabia.,Oncology Centre, Mansoura University, Mansoura, Egypt
| | - J Al-Maghrabi
- King Faisal Specialist Hospital Research Centre, Oncology, Jeddah, Saudi Arabia.,Department of Pathology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - B B Sadiq
- King Faisal Specialist Hospital Research Centre, Oncology, Jeddah, Saudi Arabia
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