Analysis of clinical characteristics of different consensus molecular subtype in colorectal cancer / 国际外科学杂志

ABSTRACT

Objective:The consensus molecular subtype (CMS) classification is based on the gene expression profiles, This article attempts to conduct a preliminary exploration and analysis of the clinical features of different CMS patients. We can give an individualized diagnosis and treatment for the patients.Methods:Seven GSE series of colorectal cancer gene expression profiles were downloaded by R software from the GEO database. A total of 1414 patients were included. Using the specific computational method published by Peter in 2017, the patients were divided into four groups CMS1, CMS2, CMS3 and CMS4. The measurement data is expressed by Mean± SD, and the count data is expressed by n(%). The software of SPSS 18.0 was used to conduct analysis. Results:CMS1 tumors originated in the right colon (77.4%), while CMS2 mostly originated in the left colon (72.8%). The proportion of T 4 stage in CMS2 was 16.6%, while in the other three types was 23.3%, 29.3% and 24% respectively; the proportion of distant metastasis of CMS1 was the lowest (3.5%), while the distant metastasis rate of CMS4 was 18.2%. The KRAS mutation rates in CMS1 and CMS2 were 25.6% and 30.3% respectively, while in CMS3 it was up to 73.9%; the BRAF mutation rate in CMS1 was 45.5%, while the other three mutation rates were 0.6%, 6.2% and 5.9%, respectively; The average mutation rate of APC was 59.45%. Overall survival and progression-free survival analysis showed that the CMS4 interstitial type was the worst, while the CMS2 classic type had the best relative prognosis. Conclusions:CMS1 immunotype, the tumor has origin from right colon in female patients. MSI-H is often accompanied by BRAF gene mutation, this type patients has a refractory treatment response and poor prognosis. The classic CMS2 type is characterized by APC deletion mutation and Wnt activation, with good therapeutic effect and good prognosis. CMS3 metabolic type often harbor KRAS mutation, anti-EGFR treatment is not sensitive. Although this type is prone to relapse, but the chemotherapy is effective, so the overall survival prognosis is acceptable. CMS4 interstitial type with left colon tumor is prevalence. due to the activation of TGF-β and enhanced angiogenesis, this type tumor is prone to metastasis to distant site and has the worst prognosis.