Study On The Relationship Between NGS Detection Of Multiple Gene Expression And Clinicopathologic Features In Advanced Non-surgical Colorectal Cancer

Objective Through the detection of mutations and expressions of related genes in blood samples of patients with advanced colorectal cancer in Inner Mongolia,the distribution characteristics of gene mutations and expressions of colorectal carcinoma in the relevant population were obtained,and the correlation between them and the clinicopathologic features of colorectal cancers was further analyzed,so as to better guide individualized targeted therapy,at the same time,it also provides a reference for evaluating the prognosis of treatment.Methods A total of 60 patients with advanced and inoperable colorectal cancer admitted to the people’s hospital of Inner Mongolia autonomous region from December 2017 to December 2018 were collected.NGS liquid biopsy was used to detect the expression of KRAS,NRAS,BRAF,PIK3 CA,PTEN and EGFR genes in plasma ct DNA.Results 1.The positive expression rates of KRAS,NRAS,BRAF,PIK3 CA,PTEN and EGFR in blood samples collected from 60 patients with advanced nonsurgical colorectal cancer in Inner Mongolia were 43.3%(26/60),3.3%(2/60),6.7%(4/60),3.3%(2/60),5%(3/60),and 61.7%(37/60),respectively,the comutation rates of NRAS and KRAS were 1.7%(1/60).2.There was no significant correlation between KRAS mutation and clinicopathological features such as gender,age,lymph node metastasis and distant metastasis(P>0.05).However,the mutation rate was significantly higher in colorectal cancer patients with right colon cancer(73.7%,P=0.005),mucinous adenocarcinoma subtype(72.2%,P=0.003),and good differentiation(53.3%,P=0.007).3.No significant correlation between NRAS,PIK3 CA mutations and clinicopathological features was found.4.BRAF mutations were more common in right colon cancer(21%,P=0.01)and poorly differentiated tumors(20%,P=0.017).5.PTEN mutation was associated with tumor site,and the mutation rate of right colon cancer was higher(15.8%,P=0.033).6.Expression of EGFR was poorly differentiated(93.3%,P=0.004),mucinous adenocarcinoma type(88.9%,P=0.005),distant metastasis(71%,P=0.049)and high TNM stage(71%,P=0.049)related.Conclusion NGS-based liquid biopsy technology will provide more comprehensive genetic information for the clinic,and is another standard for clear gene expression status outside tissue detection.The majority of gene mutations in NGS blood tests in advanced colorectal cancer in Inner Mongolia are consistent with previous studies based on tissue detection in China.KRAS,BRAF,PTEN,EGFR mutations are associated with clinicopathological features.BRAF mutations are associated with KRAS and NRAS mutations.Rejection,BRAF mutations are associated with tumor location and degree of differentiation,suggesting that patients with BRAF mutations may have a higher degree of malignancy and a worse prognosis.The expression of EGFR is associated with poor tumor differentiation,mucinous adenocarcinoma typing,high TNM staging,and distant metastasis,considering that EGFR-positive individuals may have greater invasive and metastatic potential and have a worse prognosis.The results of this study found that the type of gene mutation is related to the location of colorectal cancer,the type of tumor pathology,the degree of differentiation,the presence or absence of lymph node/distant metastasis,and staging,providing molecular typing and individualized precision treatment for colorectal cancer.in accordance with.However,given the limited sample size of this study,more patients need to be followed up,and a larger sample size is needed to further verify and explore the results.