【摘要】 目的：探讨左右半结肠癌肿瘤组织中KRAS、NRAS、BRAF状态及错配修复蛋白表达与临床病理特征的关系。方法：选取2018年1月-2022年5月福建医科大学附属南平第一医院收治的149结肠癌患者作为研究对象，所有患者均采集病理标本开展荧光定量PCR扩增法及免疫组织化学法检测KRAS、NRAS、BRAF基因突变状态及错配修复蛋白表达，分析左右半结肠癌患者与KRAS、NRAS、BRAF状态、错配修复蛋白表达、临床病理特征间关系。结果：左右半结肠癌患者KRAS、NRAS基因突变方面相比，差异均无统计学意义（P>0.05）；右半结肠癌患者BRAF基因突变率[13.11%(8/61)]高于左半结肠癌[2.27%(2/88)]，差异有统计学意义（P<0.05）；右半结肠癌患者MLH1[16.39%(10/61)]、MSH6[13.11%(8/61)]、PMS2蛋白缺失率[21.31%(13/61)]均高于左半结肠癌[2.27%(2/88)、1.14%(1/88)、3.41%(3/88)]，差异均有统计学意义（P<0.05）；左右半结肠癌患者年龄、体重指数、家族史、分化程度、脉管癌栓及临床分期方面相比，差异均无统计学意义（P>0.05）；右半结肠癌患者女性占比[60.66%(37/61)]、肿瘤≥5 cm占比[57.38%(35/61)]均高于左半结肠癌患者[34.09%(30/88)、26.14%(23/88)]，神经侵犯占比[16.39%(10/61)]低于左半结肠癌患者[31.82%(28/88)]，差异均有统计学意义（P<0.05）。结论：左右半结肠癌患者在KRAS、NRAS、BRAF状态、错配修复蛋白表达及临床病理特征间存在一定差异性，右半结肠癌患者女性较多，且BRAF基因突变率高、MLH1、MSH6、PMS2蛋白缺失率高，但左半结肠癌神经侵犯风险高，还需依据疾病特征制定个体化治疗方案，以改善患者预后。更多还原

【Abstract】 Objective: To investigate the relationship between KRAS, NRAS, BRAF status, mismatch repair protein expressions and clinicopathological features in left and right colon cancer tissues. Method: A total of 149 colon cancer patients who admitted to Nanping First Hospital Affiliated to Fujian Medical University from January 2018 to May 2022 were selected as the research objects.Pathological specimens were collected from all patients to detect KRAS, NRAS, BRAF gene mutation status and mismatch repair protein expressions by fluorescence quantitative PCR amplification and immunohistochemistry, the relationship between KRAS, NRAS, BRAF status, mismatch repair protein expressions and clinicopathological features in patients with left and right colon cancer were analyzed.Result: There were no significant differences in KRAS and NRAS gene mutations between left and right colon cancer patients(P>0.05).The mutation rate of BRAF gene in right colon cancer patients [13.11%(8/61)] was higher than that in left colon cancer [2.27%(2/88)],and the difference was statistically significant(P<0.05). The protein deletion rates of MLH1 [16.39%(10/61)], MSH6 [13.11%(8/61)] and PMS2 [21.31%(13/61)] in right colon cancer patients were higher than those in left colon cancer patients [2.27%(2/88), 1.14%(1/88),3.41%(3/88)], the differences were statistically significant(P<0.05). There were no significant differences in age, body mass index, family history, differentiation degree, vascular tumor thrombus and clinical stage between left and right colon cancer patients(P>0.05). The proportion of women [60.66%(37/61)] and tumors ≥5 cm [57.38%(35/61)] in right colon cancer patients were higher than those in left colon cancer patients [34.09%(30/88), 26.14%(23/88)], the proportion of nerve invasion [16.39%(10/61)] was lower than that of left colon cancer patients [31.82%(28/88)], and the differences were statistically significant(P<0.05). Conclusion: There are some differences in KRAS, NRAS, BRAF status, mismatch repair protein expressions and clinicopathological features between left and right colon cancer patients. Right colon cancer patients are more female, and have a high BRAF gene mutation rate, MLH1, MSH6, PMS2 protein deletion rate, but a high risk of nerve invasion in left colon cancer. It is also necessary to develop individualized treatment based on disease characteristics to improve the prognosis of patients更多还原