Prognostic value of KRAS/TP53/PIK3CA in non‑small cell lung cancer

Abstract

The present study explored the association between <i>KRAS proto-oncogene GTPase (KRAS), phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit α (PIK3CA) and tumor protein p53 (TP53) mutations, and the clinical features and survival prognosis in 50 patients with non-small cell lung cancer (NSCLC). The most common concurrent single gene mutation was TP53, followed by KRAS</i> and <i>PIK3CA</i>. Co-existing mutations were found in 17 patients. <i>KRAS, PIK3CA</i> and <i>TP53</i> mutations were associated with carbohydrate antigen 19-9 expression, invasive growth, vacuolar signs and margin lobulation on chest CT. The incidence of distant metastasis (bone and adrenal) with <i>KRAS</i> and <i>TP53</i> mutations was greater than that of local metastasis (pleura). Patients with the wild-type genes experienced longer progression-free survival (PFS) times than those with <i>KRAS, TP53, KRAS/TP53 or PIK3CA/TP53 mutations. Patients with KRAS/TP53 or PIK3CA/TP53 mutations experienced shorter PFS times than those with a single KRAS or TP53 mutation. KRAS, PIK3CA and TP53 mutations were associated with distant metastases and a poor prognosis. Patients with NSCLC should receive routine KRAS, PIK3CA and TP53 gene sequencing to determine mutations for the analysis of clinical characteristics and prognosis</i>.