Demographic trends and KRAS/BRAFV600E mutations in colorectal cancer patients of South China: A single‐site report. Issue 9 (5th February 2019) - Fu, Xinhui
Abstract : The incidence of colorectal cancer (CRC) is increasing in China. Here, we aimed to evaluate the latest demographic trends and KRAS/BRAF mutations status of Chinese CRC. Five thousand five hundred and forty‐six CRC patients diagnosed from 2010 to 2017 were involved. KRAS exon 2 and BRAF V600E mutations were detected by Sanger sequencing and high‐resolution melting analysis or allelic‐specific probe method. Gene mutation profiles and clinicopathologic characteristics of 5495 patients were analyzed. The joinpoint regression model was used to predict the demographic data in 2018. We found KRAS exon 2 and BRAF V600E mutation rates were 37.7 and 2.8% in CRC patients. Tumors with KRAS exon 2 mutations were more likely to be present in female and patients aged older than 75 years, right colon and have well‐differentiated histology. Tumors with BRAF V600E mutations were more likely to be present in the female, right colon and have poorly differentiated histology. From 2010 to 2017, the percentage of colon cancer and tubular adenocarcinoma in CRC increased substantially (from 39.3 to 51.8%, from 78.6 to 93.4%, respectively). The percentage of right colon cancer increased from 18.3 to 20.5%, which predictively may keep at 22.6% in 2018. The rise trends for patients with moderate differentiation tumor or KRAS exon 2 mutated tumor were apparent (from 50.3 to 78.6%, from 32.8 to 39.7%, respectively). In conclusion, in recent 8 years, there is a shift to the colon, especially right colon in the incidence of Chinese CRC. Moreover tubular adenocarcinoma is becoming the primary histology type. Abstract : What's new? Colorectal carcinoma (CRC) is on the rise in China due to a westernized lifestyle but a thorough molecular characterization of these tumors is lacking. Here the authors determined mutation rates of KRAS and BRAF, two critical growth‐control factors, in a large study of CRC patients in China. Both mutations occurred more frequently in female patients with right‐sided CRCs but significantly differed in their differentiation state, underscoring the need for comprehensive molecular diagnostics in the management of CRC patients in China.