[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-363917-105":59,"doc-detail-363917-en":134},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":127,"head_meta":129,"extra_data":131,"updated_unix":133},105,"zh","relationship-between-kras-gene-mutation-sites-and-clinical-characteristics-in-colorectal-cancer","结直肠癌KRAS基因突变位点与临床特征的关系","","结直肠癌KRAS基因突变是关键分子特征，但不同突变位点的临床意义差异尚不清楚。本研究回顾性纳入2018年5月至2020年1月接受手术的550例患者，PCR筛查总体突变率；其中210例采用Illumina Nova进行高通量测序，明确KRAS第2号外显子第12、13位密码子的具体突变。随访至2023年12月29日，通过Cox比例风险回归评估预后独立危险因素。结果显示不同位点与淋巴结转移及原发灶体积增大存在特异关联，并识别G12C、G12D、G12V为预后独立危险因素，可用于风险分层与个体化治疗。",{"@graph":69,"@context":126},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/relationship-between-kras-gene-mutation-sites-and-clinical-characteristics-in-colorectal-cancer/363917/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/relationship-between-kras-gene-mutation-sites-and-clinical-characteristics-in-colorectal-cancer/363917.png","ImageObject",300,407,{"name":92,"@type":93},"awa","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-27","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118,122],{"name":109,"@type":110,"acceptedAnswer":111},"本研究关注结直肠癌中KRAS基因哪些突变位点？","Question",{"text":112,"@type":113},"研究重点为KRAS基因第2号外显子第12、13位密码子的具体突变类型，并分析其与临床特征与预后的关系。","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"样本来源与检测方法分别是什么？",{"text":117,"@type":113},"回顾性纳入550例手术患者，采用PCR进行KRAS突变筛查并计算总体突变率；其中210例使用Illumina Nova高通量测序以确定具体突变类型。",{"name":119,"@type":110,"acceptedAnswer":120},"哪些KRAS突变与患者死亡风险独立相关？",{"text":121,"@type":113},"Cox比例风险回归提示肿瘤分期Ⅲ~Ⅳ期及G12C、G12D、G12V突变为结直肠癌患者死亡的独立危险因素。",{"name":123,"@type":110,"acceptedAnswer":124},"不同突变位点与临床特征关联的主要结论是什么？",{"text":125,"@type":113},"G12D突变与初诊淋巴结高转移风险相关；G12A、G12C、G12S、G13D突变与原发灶直径≥4 cm（体积增大）相关。","https://schema.org",{"og:url":83,"og:type":128,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":130,"canonical":83},"index,follow",{"doc_id":132,"site_id":62},363917,1790478422,{"code":4,"msg":5,"data":135},{"doc_id":132,"user_id":136,"nickname":92,"user_avatar":137,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":143,"language_code":63,"site_id":62,"html_lang":144,"table_of_contents":145,"faqs":146,"seo_title":147,"seo_description":67,"update_tm":148,"read_time":149},3985747858093,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","结直肠癌KRAS基因突变位点与临床特征的关系  \n马怡晨1，赵九洲2，付强3，马东阳4, 5，艾克热木·玉苏甫6，刘晓莉4, 5  \n[1 .新疆医科大学第一临床医学院，乌鲁木齐830054； 2.郑州大学附属肿瘤医院(河南省肿瘤医院)分子病理科，郑州450008； 3.郑州大学附属肿瘤医院(河南省肿瘤医院)胃肠外科，郑州450008； 4.郑州大学附属肿瘤医院(河南省肿瘤医院)中西医结合肿瘤内科，郑州450008； 5.河南省恶性肿瘤中西医转化与应用工程技术研究中心，郑州450008； 6.新疆医科大学附属肿瘤医院胃肠外科，乌鲁木齐830011]  \n[摘要] 目的：结直肠癌是全球高发消化道恶性肿瘤，KRAS基因突变是其重要的分子特征，但不同突变位点的临床意义差异尚未明确。本研究探讨KRAS基因特定突变位点的分布特征，分析其与结直肠癌患者临床病理参数、生存预后的关联，为精准分层诊疗提供依据。 方法： 回顾性纳入2018年5月至2020年1月于郑州大学附属肿瘤医院接受手术治疗的550例结直肠癌患者，均留存肿瘤组织标本。采用聚合酶链反应(polymerase chain reaction， PCR)对所有标本进行KRAS基因突变筛查，计算总体突变率；采用Illumina Nova测序平台对其中的210例标本行高通量测序，明确KRAS基因第2号外显子第12、 13位密码子的具体突变类型。 收集患者年龄、性别、肿瘤分期、 淋巴结转移状态、 原发灶直径等临床病理资料，并通过门诊复查、 电话随访获取生存数据，随访截止时间为2023年12月29 日。采用单因素及多因素Cox比例风险回归模型，筛选影响患者预后的独立危险因素，变量纳入标准为单因素分析P\u003C 0. 10及临床公认的关键变量(如肿瘤分期、淋巴结转移)。 结果： 550例标本中，232例检出KRAS基因突变，总体突变率为42 . 18%。210例行高通量测序的标本中， 155例检出突变，突变率为73 . 81%；共检出7种突变类型，其中G 12D 为最常见位点(19 .52%)，其次为G12V(12 . 86%)、 G 13D(12 . 86%)、 G 12S(10 .95%)、 G 12A(8 .57%)、 G 12C(8 . 10%)、 双突变(G 12D+G12V、 G 12V+G 13D，各占0 .48%)。 临床特征关联分析显示： G 12D突变型患者初诊时淋巴结转移比例为73 . 17%(30/41)，显著高于野生型的38 . 18%(21/55；P\u003C0 .05)，而原发灶直径≥4 cm的比例(36 .59%)与野生型(25 .45%)比较，差异无统计学意义(P>0.05)； G 12A、 G 12C、 G 12S、 G 13D突变型患者原发灶直径≥4 cm的比例分别为66 .67%、 76.47%、 78.26%、 66.67%，均显著高于野生型(均P\u003C0 .05)，但淋巴结转移比例与野生型差异无统计学意义(P>0.05)。 Cox 比例风险回归分析结果显示：肿瘤分期Ⅲ ~ Ⅳ期(HR=1 .820， 95% CI 1.194~2.774， P=0 .005)、 G 12C突变(HR= 2.014， 95% CI 1.321~3.069， P=0 .001)、 G 12D突变(HR=1 .857， 95% CI 1.218~2.930， P=0 .004)、 G 12V突变(HR= 1.751， 95% CI 1.149~2.669，P=0 .009)是结直肠癌患者死亡的独立危险因素。 结论： KRAS基因不同突变位点与结直肠癌临床特征存在特异性关联：G 12D突变与淋巴结高转移风险相关，G 12A、 G 12C、 G 12S、 G 13D突变与原发灶体积增大相关。 G 12C、 G 12D、 G 12V突变是患者预后的独立危险因素，可作为风险分层与个体化治疗的潜在分子标志物。  \n[关键词] 结直肠癌；KRAS基因；突变位点；临床特征；高通量测序；G 12D突变；预后；淋巴结转移  \nRelationship between KRAS gene mutation sites and clinical characteristics in colorectal cancer  \nMAYichen1, ZHAO Jiuzhou2, FU Qiang3, MA Dongyang4, 5, AIKEREMU·Yusufu6, LIU Xiaoli4, 5  \n收稿日期(Date of reception)：2025-05-19  \n第一作者(First author)：马怡晨，Email: [1839881327@qq.com](1839881327@qq.com), ORCID: 0009-0003-1007-3537  \n通信作者(Corresponding author)：艾克热木·玉苏甫，主任医师，Email: [akramyusup@126. com](akramyusup@126. com), ORCID: 0000-0002-7839-6928；刘晓莉，副主任医师，Email: [liuxiaoli394@126.com](liuxiaoli394@126.com), ORCID: 0000-0002-3506-6275  \n基金项目(Foundation item)：新疆维吾尔自治区卫生健康委员会“天山英才”高层次医药卫生项目(TSYC202301B044)；河南省科技厅科技攻关项 目(232102311140)。 This work was supported by the High-level Medical and Health Project of “Tianshan Talents” by the Health Commission of the Xinjiang Uygur Autonomous Region (TSYC202301B044) and the Science and Technology Research Project of the Science and Technology Department of Henan Province (232102311140), China.  \n开放获取(Open access)：本文遵循知识共享许可协议，允许第三方用户按照署名-非商业性使用-禁止演绎4 .0(CC BY-NC-ND 4.0)的方式，在任何媒介以任何形式复制、传播本作品([https://creativecommons.org/licenses/by-nc-nd/4.0/](https://creativecommons.org/licenses/by-nc-nd/4.0/))。  \n©Journal of Central South University (Medical Science) . All rights reserved.  \n[1. First Clinical Medical College of Xinjiang Medical University, Urumqi 830054; 2. Molecular Pathology Department, Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), Zhengzhou 450008; 3. Department of Gastrointestinal Surgery, Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), Zhengzhou 450008; 4. Department of Integrative Traditional Chinese and Western Medicine for Oncology, Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), Zhengzhou 450008; 5. Henan Provincial Engineering Research Center of Transformation and Application of Traditional Chinese and Western Medicine for Malignant Tumor, Zhengzhou 450008; 6. Department of Gastrointestinal Surgery, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi 830011, China]  \nABSTRACT Objective: Colorectal cancer is a common gastrointestinal malignancy worldwide. KRAS  \ngene mutation is an important molecular feature of colorectal cancer, but the clinical significance of different mutation sites remains unclear. This study aims","cbCaisQKWUtSWpsz","https://ap.wps.com/l/cbCaisQKWUtSWpsz","pdf",610381,"Chinese","en","[摘要] \n## 目的\n## 方法\n## 结果\n## 结论\n[关键词]","[{\"question\":\"本研究关注结直肠癌中KRAS基因哪些突变位点？\",\"answer\":\"研究重点为KRAS基因第2号外显子第12、13位密码子的具体突变类型，并分析其与临床特征与预后的关系。\"},{\"question\":\"样本来源与检测方法分别是什么？\",\"answer\":\"回顾性纳入550例手术患者，采用PCR进行KRAS突变筛查并计算总体突变率；其中210例使用Illumina Nova高通量测序以确定具体突变类型。\"},{\"question\":\"哪些KRAS突变与患者死亡风险独立相关？\",\"answer\":\"Cox比例风险回归提示肿瘤分期Ⅲ~Ⅳ期及G12C、G12D、G12V突变为结直肠癌患者死亡的独立危险因素。\"},{\"question\":\"不同突变位点与临床特征关联的主要结论是什么？\",\"answer\":\"G12D突变与初诊淋巴结高转移风险相关；G12A、G12C、G12S、G13D突变与原发灶直径≥4 cm（体积增大）相关。\"}]","结直肠癌KRAS基因突变位点与临床特征的关系 | PDF",1790154188,18]