Prediction Model for KRAS Mutation Status in Colorectal Serrated Adenocarcinoma Based on Histomorphological Features and Expression of P53 and BCL-2
Colorectal cancer (CRC) is considered as major health problem, one type of cancer that most often occurs in Indonesia. Serrated colorectal adenocarcinoma (SA) is one type of CRC. One of colorectal carcinogenesis pathway is serrated pathway that known to involve KRAS gene mutation, P53
and Bcl-2. Histomorphological criteria found by Tuppurainen et al. currently used as marker of SA. Limited facilities of molecular pathology laboratory in Indonesia emphasize the needs of making scoring model by using histomorphological features of SA and/or P53 and Bcl-2 protein expression
to predict KRAS mutation. A cross sectional study conducted to 39 cases of SA registered in Departement of Anatomical Pathology FMUI/Ciptomangunkusumo Hospital from 2013–2015. Each case was reevaluated based on Tuppurainen histomorphological criteria, tumor markers (Bcl-2 and P53), and
KRAS status. Present study showed that most cases of SA was found in male (51.3%), aged ≥40 years (71.8%), located in left colon (84.6%), did not have metastasis (92.3%), with KRAS mutation status (71.8%). P53 and Bcl-2 protein expressions were found in 69.2% and 51.3% respectively, with
no significant association with KRAS status. Statistical values showed scoring models consisted of epithelial serrations, nucleus location, nucleus condition and presence of mucin (CI 95% between 61–65%). The sensitivity and specificity cut off point located on the number 16, with sensitivity
value was 72% and specificity 48%. A scoring system model yielded 16 as cut off score was obtained to predict KRAS mutations.
Keywords: Bcl2; Colorectal Cancer; Colorectal Serrated Adenocarcinoma; KRAS Mutation; P53; Serrated Pathway
Document Type: Research Article
Affiliations: Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
Publication date: 01 September 2018
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