Expression of p53 & Kras mutations with immunohistochemical markers in colorectal carcinoma in a tertiary care centre

Vijayakumar, P (2018) Expression of p53 & Kras mutations with immunohistochemical markers in colorectal carcinoma in a tertiary care centre. Masters thesis, Coimbatore Medical College, Coimbatore.

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Abstract

Colorectal carcinoma is the commonest carcinoma of the Gastrointestinal tract.P53 & Kras are the most frequently mutated genes in the colorectal carcinoma. Patients with P53 & Kras mutations are at risk for developing resistance to Epidermal growth factor inhibitors and chemotherapy. AIM: To detect the expression of p53 & Kras mutations in colorectal carcinomas with immunohistochemical markers in a tertiary care centre. MATERIAL & METHODS: Specimens of 36 cases of resected colorectal carcinomas were subjected to Hematoxylin & Eosin Staining, & Kras and P53 immunohistochemical marker studies. Datas like age gender histopathological diagnosis were analysed. STATISTICAL ANALYSIS: The association between p53 & kras and each variable was evaluated. RESULTS: P53 staining was found positive in 16 out of 30 colorectal adenocarcinomas and kras was positive in 14 out of 30 colorectal adenocarcinoma patients. Well differentiated colorectal carcinoma showed high expression of P53 and kras. As the grade of colorectal carcinoma worsens the expression of P53 and kras decreases. We indirectly by IHC observe that in our setup colorectal are constituted mostly as CpG hypermethylation type without microsatelite instability which will help the oncologist to asses the prognosis and choose the mode of treatment. CONCLUSION: Kras and P53 mutations are common in colorectal carcinomas . Oncogene Kras mutation is important in the process of colorectal carcinogenesis. Kras expression is noted in 46.7% of cases in the present study. Kras mutation confers resistance to epidermal growth factor receptor inhibitors during patients treatment. Kras mutation in colorectal carcinoma is associated with poor survival of the patients along aggressive behaviour of the tumour. Tumour supressor gene P53 mutation plays a crucial role in the development of colorectal carcinoma. P53 mutations shed their tumour suppressive functions and promote tumorogenesis. P53 mutation is detrimental for the survival colorectal carcinoma patients. Many of the colorectal cases show both mutations. Kras amplification as well as Kras mutations are associated with poor response to Epidermal growth factor receptor inhibitors like cetuximab and panitusumab. P53 mutations in colorectal adenocarcinoma render the chemotherapeutic agents especially 5 fluouracil ineffective. Identification of Kras expression and P53 expression will help in redefining the targeted therapy with monoclonal antibodies and chemotherapy. Hence identification of kras expression and p53 in colorectal carcinoma using Immunohistochemistry an economical and less time consuming procedure may be more beneficial for the colorectal carcinoma patients. Routine use of p53 and Kras would help to choose individualized option treatment n colorectal carcnoma patients. Hence chemotherapy and monoclonal antibobdies therapy regimen shall be based on p53 and Kras mutation status to effectively treat the patients with colorectal carcinoma.

Item Type: Thesis (Masters)
Additional Information: Reg. NO. 201513257
Uncontrolled Keywords: p53 ; Kirsten rat sarcoma (Kras); immunohistochemical markers ; colorectal carcinoma ; tertiary care centre
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 19 Aug 2018 03:16
Last Modified: 19 Aug 2018 03:16
URI: http://repository-tnmgrmu.ac.in/id/eprint/9304

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