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...

Descripción completa

Detalles Bibliográficos
Autores: Martínez-Roca, A, Cubiella, J, García-Heredia, A, Guill-Berbegal, D, Baile-Maxía, S, Mangas-Sanjuán, C, Sala-Miquel, N, Madero-Velazquez, L, Alenda, C, Zapater, P, González-Núñez, C, Iglesias-Gómez, A, Codesido-Prado, L, Díez-Martín, A, Kaminski, MF, Erichsen, R, Adami, HO, Ferlitsch, M, Pellisé, M, Holme, O, Dekker, E, Bretthauer, M, Jover, R
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
Descripción
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.