Detecting KRAS and its mutations in biopsy of advanced colorectal carcinoma during colonoscopy

Czech version

Authors: Z. Beneš ¹; J. Abrahámová ²; M. Matějčková ³; Z. Antoš ¹; G. Puškárová ¹; P. Kohout ¹; M. Rozmahel ¹; A. Hep ⁴; Jiří Dolina ⁴; F. Koukolík ³
Authors‘ workplace: II. interní klinika Thomayerovy nemocnice Praha, přednosta doc. MUDr. Zdeněk Beneš, CSc. ¹; Onkologická klinika 1. lékařské fakulty UK a Thomayerovy nemocnice Praha, přednostka prof. MUDr. Jitka Abrahámová, DrSc. ²; Oddělení patologie a molekulární medicíny Thomayerovy nemocnice Praha, přednosta prim. MUDr. František Koukolík, DrSc. ³; Gastroenterologická klinika Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Aleš Hep, CSc. ⁴
Published in: Vnitř Lék 2012; 58(7 a 8): 186-189
Category: 60th Birthday prof. MUDr. Miroslav Souček, CSc.

Overview

Colorectal carcinoma (CRC) is a very frequent malignant cancer in the Czech Republic. In recent years, significant advances have occurred in its detection and treatment. New medication has been developed that acts upon the EGRF domain expressed on the surface of cancer cells. The most important agents of this targeted treatment are cetuximab and panitumumab. Nevertheless, a known aspect of this treatment is that their efficacy is significantly reduced upon the detection of a KRAS mutation in the cancerous tissue. Usually, the evaluation of KRAS is performed on malignant tissue within the resected material. There are, nevertheless, situations where targeted treatment may or should precede a surgical procedure (the ill patient refuses an operation, a surgical procedure is unable to be performed due to co-morbidity, a cetuximab treatment is planned in CRC liver metastases): in these afflicted patients, it is necessary to perform a KRAS evaluation already during a colonoscopy with biopsy. The goal of this study was to determine and demonstrate that an evaluation of KRAS or its mutations may be performed in a biopsy. We examined 74 afflicted patients that underwent a colonoscopy with biopsy. 26 afflicted patients had demonstrated a KRAS mutation in the biopsy, which is 35 %. It may thus be stated, that a KRAS evaluation may be performed from an endoscopic biopsy, which assists in accelerating and improving the quality via targeted treatment in afflicted patients with metastatic CRC.

Key words:
colonoscopy – colorectal neoplasma – KRAS genes – mutation

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