Prediction of metachronous advanced colorectal neoplasia by <i>KRAS</i> mutation in polyps
Background: The potential of molecular markers in the removed polys as reliable predictors of metachronous lesions is still uncertain. Aim: Our aim was to evaluate the role of somatic mutations in KRAS in polyps of patients with high-risk adenomas to predict the risk of advanced polyps or colorectal...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2024 |
| País: | España |
| Institución: | Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL) |
| Repositorio: | r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante |
| OAI Identifier: | oai:isabial.fundanetsuite.com:p10446 |
| Acceso en línea: | https://isabial.portalinvestigacion.com/publicaciones10446 https://onlinelibrary.wiley.com/doi/10.1002/ueg2.12667 |
| Access Level: | acceso abierto |
| Palabra clave: | colonic polyps colorectal cancer KRAS mutation surveillance tumor markers |
| Sumario: | Background: The potential of molecular markers in the removed polys as reliable predictors of metachronous lesions is still uncertain. Aim: Our aim was to evaluate the role of somatic mutations in KRAS in polyps of patients with high-risk adenomas to predict the risk of advanced polyps or colorectal cancer (CRC) within 3 years. Methods: A total of 518 patients were prospectively enrolled. The included patients had adenomas >= 10 mm, high-grade dysplasia, villous component or >= 3 more adenomas at baseline and were scheduled to undergo surveillance colonoscopy at 3 years 6 months. Somatic KRAS mutation was performed on 1189 polyps collected from these patients. At surveillance, advanced lesions were defined as adenomas with a size of >= 10 mm. High-grade dysplasia or villous component, serrated polyps >= 10 mm or with dysplasia or CRC. Results: At baseline, 81 patients (15.6%) had KRAS mutations in at least one polyp. Patients with KRAS mutated polyps had more frequent villous histological lesions and size >= 20 mm. In the multivariate analysis, adjusted for age and sex, only age (odds ratios [OR], 1.06; 95% confidence interval [CI], 1.02-1.09; p < 0.001), >= 5 adenomas (OR, 3.92; 95% CI, 1.96-7.82), and KRAS mutation (OR, 2.54; 95% CI, 1.48-4.34; p < 0.01) were independently associated with the development of advanced lesions at surveillance. Conclusions: Our results show that, in patients with high-risk adenomas, the presence of somatic mutations in KRAS is an independent risk factor for the development of advanced metachronous polyps. |
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