K-ras mutation detection using a novel amplification refractory mutation system-based quantitative polymerase chain reaction with locked nucleic acid blocker in plasma among colorectal cancer patients
2017
Objective
To determine whether plasma circullating cell-free DNA (cfDNA) is a viable alternative approach for K-ras mutation testing in colorectal cancer (CRC) patients.
Methods
The study included 155 CRC patients. An a novel amplification refractory mutation system-based quantitative polymerase chain reaction with locked nucleic acid (LNA-ARMS-PCR) was developed to assess the K-ras mutation in preoperative plasma and paired tumor tissues. Firstly intra-tumoral heterogeneity analysis was used to determine whether it was a robust mutation detection method for the detection of low-abundance K-ras mutations.
Results
The newly built LNA-ARMS-PCR was a robust mutation detection method to escape the most false negative caused by intra-tumoral heterogeneity. The positive consensus rate and negative consensus rate was 35.3% and 100.0%, between plasma and tumor tissue K-ras mutation detection, respectively. The majority of K-ras mutations detected in tumors were also found in plasma(15/18 (83.3%)) in patients of stage Ⅳ. The accordance of plasma and tumor mutation are strongly correlated to TNM stage and cfDNA level.
Conclusion
K-ras analysis in plasma cfDNA is only a viable alternative to tissue analysis in mCRC (stage Ⅳ). Quantitative levels of cfDNA and plasma mutation positivity are strongly correlated.
Key words:
Colorectal cancer; K-ras; Locked nucleic acid; Amplification refractory mutation system
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