Open AccessKRAS and BRAF somatic mutations in colonic polyps and the risk of metachronous neoplasia
Author(s) -
Míriam Juárez,
Cecilia Egoavil,
María RodríguezSoler,
Eva HernándezIllán,
Carla Guarinós,
Araceli GarcíaMartínez,
Cristina Alenda,
Mar Giner-Calabuig,
Óscar Murcia,
Carolina Mangas,
Artemio Payá,
José Ramón Aparicio,
F Ruiz,
Juan Martínez,
Juan Antonio Casellas,
José Luís Soto,
Pedro Zapater,
Rodrigo Jover
Publication year - 2017
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0184937
Subject(s) - kras , medicine , dysplasia , colonoscopy , gastroenterology , hyperplastic polyp , univariate analysis , splenic flexure , multivariate analysis , colorectal cancer , oncology , cancer
Background & aims High-risk features of colonic polyps are based on size, number, and pathologic characteristics. Surveillance colonoscopy is often recommended according to these findings. This study aimed to determine whether the molecular characteristics of polyps might provide information about the risk of metachronous advanced neoplasia. Methodology We retrospectively included 308 patients with colonic polyps. A total of 995 polyps were collected and tested for somatic BRAF and KRAS mutations. Patients were classified into 3 subgroups, based on the polyp mutational profile at baseline, as follows: non-mutated polyps (Wild-type), at least one BRAF -mutated polyp, or at least one KRAS -mutated polyp. At surveillance, advanced adenomas were defined as adenomas ≥ 10 mm and/or with high grade dysplasia or a villous component. In contrast, advanced serrated polyps were defined as serrated polyps ≥ 10 mm in any location, located proximal to the splenic flexure with any size or with dysplasia. Results At baseline, 289 patients could be classified as wild-type (62.3%), BRAF mutated (14.9%), or KRAS mutated (22.8%). In the univariate analysis, KRAS mutations were associated with the development of metachronous advanced polyps (OR: 2.36, 95% CI: 1.22–4.58; P = 0.011), and specifically, advanced adenomas (OR: 2.42, 95% CI: 1.13–5.21; P = 0.023). The multivariate analysis, adjusted for age and sex, also showed associations with the development of metachronous advanced polyps (OR: 2.27, 95% CI: 1.15–4.46) and advanced adenomas (OR: 2.23, 95% CI: 1.02–4.85). Conclusions Our results suggested that somatic KRAS mutations in polyps represent a potential molecular marker for the risk of developing advanced neoplasia.