Didar GÜRSOY, İlke Evrim SEÇİNTİ, Esin DOĞAN, Muhyittin TEMİZ

Mide Kanserlerinin Klinikopatolojik Özellikleri ve KRAS-mutasyon İnsidansı

Amaç: Bu çalışmanın amacı, Hatay ilinde mide adenokarsinomlu (GAC) hastalarda KRAS mutasyonlarının sıklığını, bu mutasyonun bazı patolojik ve klinik parametrelerle ilişkisini belirlemek, hastaların tanı ve tedavi planlamasına rehberlik etmektir. Gereç ve Yöntem: KRAS mutasyonunun değerlendirilmesinde formalinle fikse, parafine gömülmüş ve histolojik olarak tanıları doğrulanmış örnekler kullanıldı. Her vakanın arşiv doku örneklerinden kesitler alındı. RAS geninin 12 ve 13 kodonlarının (ekson 2) mutasyonlarını belirlemek için Gerçek Zamanlı Polimeraz Zincir Reaksiyonu (RT-PCR) sistemi kullanıldı. GLY12ALA (G12A), GLY12ASP (G12D), GLY12ARG (G12R), GLY12CYS (G12C), GLY12SER (G12S), GLY12VAL (G12V), GLY13ASP (G13D) mutasyonları çalışıldı. Bulgular: KRAS mutasyon oranı %2 idi ve sadece G12D tespit edildi. Bu olguda, tümör küçük kurvatur yerleşimliydi. Mutasyonlu olgu sayısı az olduğundan KRAS mutasyonu ile klinikopatolojik faktörler arasında istatistiksel karşılaştırma yapılamadı. Tümör diferansiyasyonu ile WHO-2010 tiplemesi ve primer tümör evresi arasında anlamlı bir fark bulundu. Sonuç: KRAS mutasyonu insidansını %2 olarak bulduk. GAC'deki KRAS mutasyonu tek başına prognostik veya prediktif bir belirteç olmasa da, alt tipe özgü analiz, hastalığın tanısını, yönetimini ve tedavisini etkileyebilecek veriler sağlayabilir.

Anahtar Kelimeler:

KRAS, mide kanseri, G12D, mutasyon

Clinicopathologic features and KRAS mutation incidence of gastric carcinomas

Objectives: This study aims to determine the frequency of KRAS mutations in patients with gastric adenocarcinoma (GAC) in Hatay province, and to determine the relationship of this mutation with some pathological and clinical parameters and to guide the diagnosis and treatment planning of patients. Methods: Formalin-fixed, paraffin-embedded, and histologically confirmed samples were used in the assessment of KRAS mutation. Sections were taken from the archive tissue samples of each case. Real-Time Polymerase Chain Reaction (RT-PCR) system was used to identify mutations of codons 12 and 13 (exon 2) of the RAS gene. Mutations of GLY12ALA (G12A), GLY12ASP (G12D), GLY12ARG (G12R), GLY12CYS (G12C), GLY12SER (G12S), GLY12VAL (G12V), GLY13ASP (G13D) were performed. Results: The mutation rate of KRAS was 2% and only one substitution, G12D, was detected. In this case, the tumor was located in the small curvature. Since the number of cases with mutations was low, statistical comparison could not be made between KRAS mutation and clinicopathological factors. A significant difference was found between tumor differentiation and WHO-2010 typing and primary tumor stage. Conclusions: We found the incidence of KRAS mutation to be 2%. We also estimate that the G12D mutation may be associated with GAC site and surgical margin. Although KRAS mutation in GAC alone is not a prognostic or predictive marker, subtype-specific analysis may provide data that may affect the diagnosis, management and treatment of the disease

Keywords:

kras, gastric carcinoma, G12D, mutation,

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