• Chun-Chi Lin, Jen-Kou Lin, Tzu-Chen Lin, Wei-Shone Chen, Shung-Haur Yang, Huann-Sheng Wang, Yuan-Tzu Lan, Jeng-Kai Jiang, Muh-Hwa Yang, and Shih-Ching Chang.
• Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan; National Yang-Ming University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-M... more ing University, Taipei, Taiwan. less
• J Surg Oncol. 2014 Sep 1; 110 (4): 451-7.

BackgroundThis study aimed to establish a correlation between MSI, KRAS mutations, and BRAF(V600E) in colon cancer and to investigate the prognostic effect.MethodsColon cancer patients who underwent surgical intervention were enrolled. MSI status was identified by genotyping, and the mutational statuses of KRAS and BRAF were determined by MassARRAY, targeting 22 mutations. The clinicopathological differences and correlations between these factors were analyzed.ResultsAmong 1,063 patients, tumors with MSI-H were significantly associated with BRAF(V600E) (P = 0.001). KRAS and BRAF mutations were mutually exclusive (P = 0.001). Patients with MSI-H tumors had significantly improved overall survival compared with patients that had microsatellite instability-low/stable (MSI-L/MSS) tumors (hazard ratio 0.686: 95% confidence interval: 0.479-1.162, P = 0.040). In addition, the BRAF(V600E) mutation was a poor prognostic factor in tumors with MSI-L/MSS (P = 0.020). KRAS mutations were not prognostic factors, but sub-group analysis demonstrated that mutations in KRAS codon 12 were associated with significantly worse survival than wild-type KRAS, mutations in KRAS codon 13, or mutations elsewhere.ConclusionsMSI and the BRAF(V600E) mutation have a prognostic impact in colon cancer. Variable KRAS mutations may have different effects on colon cancers; further studies are needed to verify these results.© 2014 Wiley Periodicals, Inc.

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