Clinicopathological Evaluation of KRAS Mutations and Their Relationship with P21 Immunohistochemical Expression in Colorectal Carcinoma

Abstract

Purpose: This study aims to evaluate the clinicopathological significance of KRAS mutations and the immunohistochemical expression of p21 in colorectal carcinoma (CRC), and to explore their correlation with various pathological parameters. Materials and Methods: A total of 30 metastatic CRC cases diagnosed and/or treated at Ankara Oncology Training and Research Hospital were retrospectively analyzed. KRAS mutation analysis was conducted using pyrosequencing, and p21 expression was evaluated via immunohistochemistry. Associations between KRAS mutation status, p21 expression, and clinicopathological variables including tumor grade, size, invasion depth, and lymph node status were statistically analyzed. Results: KRAS mutations were identified in 15 (50%) of the cases, with codon 12 mutations being the most frequent. p21 nuclear expression was observed more commonly in KRAS mutant tumors. A significant association was found between p21 expression and pathological tumor invasion depth. No significant correlation was detected between KRAS mutations and tumor localization, grade, or other parameters. Conclusion: KRAS mutations, particularly at codon 12, are common in CRC and may influence p21 expression. The findings suggest a potential link between KRAS mutation and the molecular regulation of p21, warranting further investigation in larger cohorts.

Keywords

• Colorectal carcinoma
• KRAS mutation
• p21
• immunohistochemistry
• clinicopathological correlation

Kolorektal Karsinomlarda KRAS Mutasyon Varlığının ve p21 İmmünohistokimyasal Ekspresyonunun Klinikopatolojik Parametrelerle İlişkisi

Abstract

Amaç: Bu çalışmada, kolorektal karsinom (KRK) olgularında KRAS mutasyonlarının klinikopatolojik önemi ile p21 immünohistokimyasal ekspresyonu değerlendirilmiş ve bu biyobelirteçlerin çeşitli patolojik parametrelerle ilişkisi araştırılmıştır. Gereç ve Yöntem: Ankara Onkoloji Eğitim ve Araştırma Hastanesi’nde tanı almış ve/veya tedavi edilmiş 30 metastatik KRK olgusu retrospektif olarak incelenmiştir. KRAS mutasyon analizi pirodizi yöntemiyle, p21 ekspresyonu ise immünohistokimyasal olarak değerlendirilmiştir. KRAS mutasyon durumu, p21 ekspresyonu ve klinikopatolojik değişkenler (tümör derecesi, boyutu, invazyon derinliği, lenf nodu durumu vb.) arasındaki ilişkiler istatistiksel olarak analiz edilmiştir. Bulgular: Olguların %50’sinde KRAS mutasyonu saptanmış olup, en sık mutasyon kodon 12’de gözlenmiştir. KRAS mutasyonlu olgularda p21 nükleer ekspresyonu daha yaygındı. p21 ekspresyonu ile patolojik tümör invazyon derinliği arasında anlamlı ilişki bulunmuştur. KRAS mutasyonu ile tümör lokalizasyonu, derecesi veya diğer parametreler arasında anlamlı bir ilişki saptanmamıştır. Sonuç: KRAS mutasyonları, özellikle kodon 12 düzeyindeki değişiklikler, KRK olgularında yaygın olarak gözlenmektedir ve p21 ekspresyonunu etkileyebilmektedir. Bulgular, KRAS mutasyonu ile p21’in moleküler düzenlenmesi arasında olası bir ilişki olduğunu düşündürmekte olup, daha geniş örneklem gruplarında yapılacak ileri çalışmalarla desteklenmelidir.

Keywords

• Kolorektal karsinom
• KRAS mutasyonu
• p21
• immünohistokimya
• klinikopatolojik korelasyon

Ethical Statement

ETİK KURUL ONAY BELGESİ Bu çalışma için Dr. Abdurrahman Yurtaslan Ankara Onkoloji Eğitim ve Araştırma Hastanesi Klinik Araştırmalar Etik Kurulu’ndan 22.03.2012 tarihinde, 2012/108 sayılı karar ile etik kurul onayı alınmıştır. Karar No: 2012/108 Karar Tarihi: 22.03.2012 Etik Kurul: Dr. Abdurrahman Yurtaslan Ankara Onkoloji EAH Klinik Araştırmalar Etik Kurulu Araştırmacı: Dr. Burçin Çelik Çalışma Başlığı: Kolorektal Karsinomlarda K-RAS Mutasyon Varlığının ve P21 İmmünohistokimyasal Ekspresyonunun Klinikopatolojik Parametrelerle İlişkisi

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