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Evaluation and identification of factors related to KRAS and BRAF gene mutations in colorectal cancer: A meta-analysis


1 Department of Gastrointestinal Oncology, Affiliated Hospital Cancer Center, Academy of Military Medical Sciences, Beijing, People's Republic of China
2 Department of Pathology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
3 Department of Pathology, Affiliated Hospital Cancer Center, Academy of Military Medical Sciences, Beijing, People's Republic of China
4 Department of Integrated Chinese Traditional Medicine and Western Medicine, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China

Correspondence Address:
Mei-yu Fang,
Department of Integrated Chinese Traditional Medicine and Western Medicine, Zhejiang Cancer Hospital, No. 38 Guangji Road, Gongshu District, Hangzhou, Zhejiang 310022
People's Republic of China
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Source of Support: None, Conflict of Interest: None

Objective: The aim of this meta-analysis is the distribution pattern of KRAS and BRAF mutations in colorectal cancer (CRC). Materials and Methods: The database was searched without language restrictions. Meta-analyses were conducted using the Stata software. We calculated the odds ratio (OR) and its 95% confidence interval to estimate the distribution of and correlation between KRAS and BRAF mutations, CpG island methylator phenotype (CIMP), and microsatellite instability (MSI) in the left- and right-sided CRC. Results: The studies were divided into five groups: (1) Distribution of KRAS/BRAF mutations in distal and proximal CRCs, the summary OR value was 1.24 versus 4.03, (2) distribution of KRAS/BRAF mutations in CIMP-low/negative and CIMP-high (CIMP-H) tumors, the summary OR value was 0.77 versus 10.49, (3) distribution of KRAS/BRAF mutations in MSI-low (MSI-L)/microsatellite stable (MSS) and MSI-high (MSI-H) tumors, the summary OR value was 0.51 versus 9.60, (4) proportion of CIMP-H/MSI-H tumors among distal and proximal colorectal tumors, the summary OR value was 3.66 versus 6.54, and (5) proportion of CIMP-H tumors among MSI-L/MSS and MSI-H tumors, the summary OR value was 5.87. Conclusion: The meta-analysis reveals that KRAS has a slightly higher mutation rate in MSI-L/MSS tumors. Moreover, BRAF mutations have a higher detection rates in the right-sided CRC, which suggests that BRAF mutations are likely in CIMP-H tumors. Therefore, based on these findings, the molecular diagnostic tests to be conducted in CRC patients can be determined according to the location/clinical features of the tumor.


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