结直肠癌患者肠道黏膜菌群多样性变化研究

目的应用PCR-DGGE技术对结直肠癌患者肠道黏膜局部菌群多样性进行研究,为结直肠病变的防治提供微生态调节思路。方法收集正常对照组、结直肠息肉组及结直肠癌组患者各30例,采集结直肠黏膜局部肛拭子,提取细菌基因组DNA,采用PCR-DGGE对肠道黏膜局部菌群进行指纹图谱分析。结果正常对照组、结直肠息肉组和结直肠癌组患者PCR-DGGE指纹图谱分析显示3组肠道黏膜局部菌群多样性发生了显著的变化,3组肠道黏膜局部菌群发生了显著的菌群变迁。结论 PCR-DGGE分析结直肠癌患者肠道黏膜局部菌群多样性变化对监测肠道局部微生态变化在结直肠癌的发生过程中的作用具有重要价值。     

基于16S rRNA和非靶向代谢组测序分析结直肠癌患者肠道菌群及代谢物的变化

目的 采用16S rRNA和非靶向代谢组测序分析的方法探讨结直肠癌患者肠道菌群和其代谢产物的变化。方法 新鲜粪便为实验样品,收集10个结直肠癌患者组样本和6个正常对照组样本进行16S rRNA测序,分析肠道菌群的组成、多样性和物种差异,并对预测差异肠道菌群代谢功能;取8个结直肠癌组样本和6个正常对照组样本进行LC-MS非靶向代谢组学测序,分析代谢产物变化情况并进行功能预测。结果 结直肠癌组的菌群多样性较正常对照组无显著差异（P>0.05）。结直肠癌组的优势菌群为疣微菌门,结直肠癌组葡萄球菌、嗜冷杆菌属、毛螺菌科NK4A136、梭状芽孢杆菌vadinBB60和CAG-56相对丰度增加（P<0.05）,CAG-352、瘤胃球菌属、粪球菌属和挑剔真杆菌相对丰度降低（P<0.05）。KEGG富集分析发现,差异菌群在环境信息处理、遗传信息处理和新陈代谢等通路中发挥重要作用。非靶向代谢组学测序检测出两组样本有367种代谢物存在显著差异,对差异代谢物进行功能预测发现与咖啡因、嘌呤、氨基糖和核苷酸糖和生物素等的代谢相关。结论 结直肠癌患者的肠道菌群和代谢物与健康个体存在差异,结直肠癌...     

MMP-7和Survivin在结直肠癌中的表达及其临床意义

目的探讨Wnt信号通路中基质金属蛋白酶7（matrix melluoproteinases7,MMP-7）和凋亡抑制基因Survivin在结直肠癌组织中表达及其与临床病理特征的关系。方法应用免疫组织化学染色（Elivision）方法检测100例结直肠癌组织和60例癌旁正常黏膜组织中MMP-7和Survivin蛋白的表达。结果MMP-7蛋白在100例结直肠癌组织和60例癌旁正常黏膜组织中的阳性表达率分别为77．00％（77／100）和13．33％（8／60）,两组问差异有统计学意义（P〈0．01）;Survivin蛋白在100例结直肠癌组织和60例癌旁正常黏膜组织中的阳性表达率分别为65．00％（65／lOO）和15．00％（9／60）,两组问差异有统计学意义（P〈0．01）。MMP-7与Survivin蛋白阳性表达均与肿瘤的淋巴结转移和Dukes分期有关（P〈0．05）,此外,MMP-7蛋白在结直肠癌中的阳性表达也与肿瘤的浸润深度有关（P〈0．05）。而MMP-7与Survivin蛋白的阳性表达无相关性（r=0．097,P〉O．05）。结论MMP-7和Survivin在结直肠癌中的高表达可能与结直肠癌的发生、发展、浸润和转移等相关,检测癌组织中MMP-7和Survivin的表达有助于为结直肠癌的病情进展及预后判断提供帮助。     

实时荧光定量PCR法研究结直肠癌患者肠道拟杆菌属、梭杆菌属和梭菌属量的变化

目的通过研究结、直肠癌患者肠道拟杆菌属、梭杆菌属和梭菌属量的变化,揭示肠道相关菌群改变在大肠癌发病中的作用及意义。方法收集术前结、直肠癌患者粪便标本40例及正常对照标本40例,根据细菌的靶基因序列设计特异性引物。提取待测粪便标本细菌DNA,应用SYBR Green I实时荧光定量PCR测定不同细菌的数量。结果正常对照组与实验组粪便中细菌数量分别为拟杆菌属(8.76±0.77;9.85±0.88)、梭杆菌属(7.94±1.25;10.0±1.65)、梭菌属(3.54±0.70;6.56±0.68),拟杆菌属中的脆弱拟杆菌为(2.12±0.48;4.07±1.77)、梭杆菌属中的坏死梭杆菌为(2.31±0.26;7.62±2.68)及梭菌属中的肉毒梭菌为(2.76±1.16;5.43±1.21),实验组数量均明显增多(P0.05)。结论结、直肠癌患者粪便中拟杆菌属、梭杆菌属和梭菌属的数量较正常对照明显增多,提示结、直肠癌的发生发展与肠道菌群有明显关系。     

肝癌微血管浸润相关长链非编码RNA(lncRNA-MVIH)在结直肠癌中的表达

为了探讨长链非编码RNA肝癌微血管浸润相关mRNA(MVIH-lncRNA)在结直肠癌中的表达及其临床意义。本研究采用实时荧光定量PCR(RT-q PCR)检测MVIH-lncRNA在44例结直肠癌组织、44例癌旁组织和13例正常结肠组织中表达。研究结果表明:MVIH-lncRNA在结直肠癌组织中的表达显著高于癌旁组织(p0.001)和正常结肠组织(p0.001),并且MVIH-lncRNA的表达在正常结肠组织、癌旁组织、结直肠癌组织中呈递增趋势(p0.001)。高表达MVIH-lncRNA与淋巴结转移相关,而与年龄、性别、肿瘤大小、肿瘤分化不相关;MVIH-lncRNA表达上调患者生存时间更短(p=0.034),其在结直肠中高表达提示预后不良。本研究的结果表明MVIH-lncRNA在结直肠癌的早期诊断、预后评价中的具有重要的意义,为进一步研究MVIH-lncRNA在结直肠癌的发生发展中的分子机理奠定了研究基础。     

肠道菌群稳态与结直肠癌研究进展

结直肠癌是一种涉及遗传、环境和生活方式等多风险因素的疾病。越来越多的研究表明肠道菌群在结直肠癌的发生发展中起重要作用,菌群与消化道之间的共生作用对维持肠道内环境的稳定也十分重要。菌群在炎症、药物代谢,甚至癌症的发展中扮演着许多角色,然而由感染、饮食或生活方式等变化引起的菌群组成的改变却可影响这种共生关系。同样,菌群组成的变化使部分菌种在肠内引发炎症反应甚至致癌,从而对结肠直肠癌的发生发展产生实质性的影响,综述将总结目前肠道菌群与结直肠癌之间潜在的联系,重点关注细菌在肠道中所参与的各种反应,从而为治疗结直肠癌提供更多的研究思路。     

结直肠癌组织RPN11与Ki67的表达及其临床病理学意义

目的观察去泛素化酶RPN11和增殖相关核标记物Ki67在结直肠癌组织中的表达,研究其与结直肠癌肿瘤细胞增殖的相关性及与结直肠癌临床病理特征的关系。方法采用免疫组织化学SABC法检测56例结直癌组织及20例癌旁正常组织中的RPN11和Ki67表达,结合临床病理学资料进行统计分析。结果免疫组织化学染色显示:RPN11及Ki67在结直肠癌组织的阳性表达率明显高于正常结直肠组织;RPN11和Ki67的表达均与肿瘤分化程度、TNM分期、转移有关,而与性别、年龄无明显相关;RPN11与Ki67的表达呈正相关。结论RPN11和Ki67可能共同参与结直肠癌肿瘤细胞的增殖调控,并促进结直肠癌的发生发展以及浸润转移。     

双歧三联活菌胶囊对结直肠癌术后肠道菌群及肠黏膜通透性的影响

目的探讨双歧三联活菌胶囊对结直肠癌术后肠道菌群及肠黏膜通透性的影响。方法选取拟行手术治疗的结直肠癌患者78例,随机分为观察组和对照组。两组患者术前常规禁食、肠道准备,采用开放根治性结/直肠癌切除手术治疗,术后予以围手术期常规治疗,并予以等氮量、等热量的营养支持。观察组术后第3天加用双歧三联活菌胶囊630mg/次,2次/d,连用7d。观察两组患者术前及治疗7d后肠道菌群(双歧杆菌、乳酸杆菌、大肠埃希菌和粪肠球菌)及肠黏膜通透性指标[血清二胺氧化酶(DAO)]的变化,并比较感染并发症的发生率。结果治疗7d后,两组患者双歧杆菌、乳酸杆菌和粪肠球菌数量较前明显下降,大肠埃希菌数量较前明显上升(t=2.17、2.25、2.21、2.32、2.89、3.08、2.97、3.12,P0.05或P0.01),且观察组下降或上升的幅度明显小于对照组(t=2.14、2.25、2.18、2.23,P0.05);两组血清DAO水平均较前明显上升(t=2.27、3.21,P0.05或P0.01),且观察组上升幅度明显小于对照组(t=2.23,P0.05);同时观察组患者感染并发症的总发生率明显低于对照组(χ2=5.03,P0.05)。结论结直肠癌术后存在一定程度的肠道菌群的紊乱,肠黏膜通透性上升和肠道屏障功能受损。双歧三联活菌胶囊用于结直肠癌术后可纠正与调节肠道菌群的紊乱,降低肠黏膜通透性,保护与修复肠黏膜屏障功能,从而减少或避免肠道细菌和内毒素的移位,降低感染并发症的发生。     

CCNB2在结直肠癌中的表达及临床意义

目的:探讨细胞周期蛋白B2(Cyclin B2,CCNB2)在结直肠癌组织中的表达及其临床意义。方法:选择45对结直肠癌组织及癌旁正常结直肠组织样本,分别采用实时定量PCR(qRT-PCR)方法和免疫组织化学技术检测CCNB2的mRNA和蛋白表达,并进一步分析CCNB2的表达与结直肠癌临床病理特征之间的关系。结果:结直肠癌组织中CCNB2 mRNA的表达显著高于癌旁正常结直肠组织,差异有统计学意义(P0.001),且CCNB2的mRNA表达与结直肠癌的肿瘤大小、浸润深度及TNM分期显著相关(P0.05),与年龄、性别、肿瘤位置、分化程度、脉管神经浸润、淋巴结转移和远处转移均无关(P0.05)。45例结直肠癌标本中39例表达(+~+++),6例表达(-)。CCNB2蛋白主要表达于结直肠癌细胞质中,少量见于细胞核。结直肠癌组织中CCNB2蛋白的阳性表达率为86.7%,显著高于癌旁正常结直肠组织,并与患者的性别、年龄、分化程度和肿瘤转移均无显著相关性(P0.05),但与肿瘤分期、浸润程度均显著相关(P0.05)。结论:CCNB2在结直肠癌中呈异常高表达,且与结直肠癌的发生发展相关,有望作为结直肠癌的诊断和预后预测参考指标。     

甘油二酯激酶α在结直肠癌中的表达及其与PKC、TNFα的相关性

目的探讨甘油二酯激酶α(DGKα)在结直肠癌中的表达及其与蛋白激酶C(PKC)、肿瘤坏死因子α(TNFα)表达的相关性。方法应用免疫组化方法检测DGKα、PKC和TNFα在48例结直肠癌、癌旁正常组织和9例腺瘤性息肉中的表达。结果 DGKα在结直肠癌组织和癌旁正常组织有表达,结直肠癌组织中DGKα阳性表达率(79.2%)显著高于腺瘤性息肉(阴性)和癌旁正常组织(33.3%,P0.05);PKC主要分布在结直肠癌和癌旁正常组织中,结直肠癌组织中PKC阳性表达率(35.4%)显著高于腺瘤性息肉(阴性),与癌旁正常组织(20.8%)相比无显著性差异(P0.05);TNFα在三种组织中均表达阳性,结直肠癌组织中TNFα阳性表达率(95.8%)显著高于腺瘤性息肉(55.6%,P0.05),与癌旁正常组织(87.5%)相比无显著性差异(P0.05);结直肠癌组织中,DGKα与PKC的表达呈负相关(r=-0.437,P0.05),与TNFα的表达没有相关性(r=0.185,P0.05)。结论DGKα在结直肠癌组织中的表达高于腺瘤性息肉,DGKα可能抑制了PKC的活性,但对TNFα没有明显的抑制作用,在临床病理鉴别诊断中有辅助价值。     

Human intestinal lumen and mucosa-associated microbiota in patients with colorectal cancer

Recent reports have suggested the involvement of gut microbiota in the progression of colorectal cancer (CRC). We utilized pyrosequencing based analysis of 16S rRNA genes to determine the overall structure of microbiota in patients with colorectal cancer and healthy controls; we investigated microbiota of the intestinal lumen, the cancerous tissue and matched noncancerous normal tissue. Moreover, we investigated the mucosa-adherent microbial composition using rectal swab samples because the structure of the tissue-adherent bacterial community is potentially altered following bowel cleansing. Our findings indicated that the microbial structure of the intestinal lumen and cancerous tissue differed significantly. Phylotypes that enhance energy harvest from diets or perform metabolic exchange with the host were more abundant in the lumen. There were more abundant Firmicutes and less abundant Bacteroidetes and Proteobacteria in lumen. The overall microbial structures of cancerous tissue and noncancerous tissue were similar; however the tumor microbiota exhibited lower diversity. The structures of the intestinal lumen microbiota and mucosa-adherent microbiota were different in CRC patients compared to matched microbiota in healthy individuals. Lactobacillales was enriched in cancerous tissue, whereas Faecalibacterium was reduced. In the mucosa-adherent microbiota, Bifidobacterium, Faecalibacterium, and Blautia were reduced in CRC patients, whereas Fusobacterium, Porphyromonas, Peptostreptococcus, and Mogibacterium were enriched. In the lumen, predominant phylotypes related to metabolic disorders or metabolic exchange with the host, Erysipelotrichaceae, Prevotellaceae, and Coriobacteriaceae were increased in cancer patients. Coupled with previous reports, these results suggest that the intestinal microbiota is associated with CRC risk and that intestinal lumen microflora potentially influence CRC risk via cometabolism or metabolic exchange with the host. However, mucosa-associated microbiota potentially affects CRC risk primarily through direct interaction with the host.     

Raman 'optical biopsy' of human breast cancer

Raman imaging (RI) is a novel method of medical diagnostics of human breast cancer and has a potential to become a routine optical biopsy. Up to date the present study is the most statistically reliable Raman analysis based on data of normal, benign, and cancerous breast tissues for 146 patients. This paper present the first Raman 'optical biopsy' images of the normal and cancerous breast tissue of the same patient. The results presented here demonstrate the ability of Raman spectroscopy to accurately characterize cancer tissue and distinguish between normal (noncancerous), and cancerous types. The results provide evidence that carotenoids and lipids composition of cancerous breast tissues differs significantly from that of the surrounding noncancerous breast tissue and may be a key factor responsible for mechanisms of carcinogenesis. We have found that fatty acid composition of the cancerous breast tissue is markedly different from that of the surrounding noncancerous breast tissue. The cancerous breast tissue seems to be dominated by the metabolism products of the arachidonic acid - derived cyclic eicosanoids catalyzed by cyclooxygenase, while the noncancerous breast tissue is dominated by monounsaturated oleic acid and its derivatives.     

Molecular analysis of the luminal- and mucosal-associated intestinal microbiota in diarrhea-predominant irritable bowel syndrome

Alterations in the intestinal microbiota have been suggested as an etiological factor in the pathogenesis of irritable bowel syndrome (IBS). This study used a molecular fingerprinting technique to compare the composition and biodiversity of the microbiota within fecal and mucosal niches between patients with diarrhea-predominant IBS (D-IBS) and healthy controls. Terminal-restriction fragment (T-RF) length polymorphism (T-RFLP) fingerprinting of the bacterial 16S rRNA gene was used to perform microbial community composition analyses on fecal and mucosal samples from patients with D-IBS (n = 16) and healthy controls (n = 21). Molecular fingerprinting of the microbiota from fecal and colonic mucosal samples revealed differences in the contribution of T-RFs to the microbiota between D-IBS patients and healthy controls. Further analysis revealed a significantly lower (1.2-fold) biodiversity of microbes within fecal samples from D-IBS patients than healthy controls (P = 0.008). No difference in biodiversity in mucosal samples was detected between D-IBS patients and healthy controls. Multivariate analysis of T-RFLP profiles demonstrated distinct microbial communities between luminal and mucosal niches in all samples. Our findings of compositional differences in the luminal- and mucosal-associated microbiota between D-IBS patients and healthy controls and diminished microbial biodiversity in D-IBS fecal samples further support the hypothesis that alterations in the intestinal microbiota may have an etiological role in the pathogenesis of D-IBS and suggest that luminal and mucosal niches need to be investigated.     

Separation of fluorescence-labelled terminal restriction fragment DNA on a two-dimensional gel (T-RFs-2D) - an efficient approach for microbial consortium characterization

Fingerprinting techniques provide access to understanding the ecology of uncultured microbial consortia. However, the application of current techniques such as terminal restriction fragment length polymorphism (T-RFLP) and denaturing gradient gel electrophoresis (DGGE) has been hindered due to their limitations in characterizing complex microbial communities. This is due to that different populations possibly share the same terminal restriction fragments (T-RFs) and DNA fragments may co-migrate on DGGE gels. To overcome these limitations, a new approach was developed to separate terminal restriction fragments (T-RFs) of 16S rRNA genes on a two-dimensional gel (T-RFs-2D). T-RFs-2D involves restriction digestion of terminal fluorescence-labelled PCR amplified 16S rRNA gene products and their high-resolution separation via a two-dimensional (2D) gel electrophoresis based on the T-RF fragment size (1(st) D) and its sequence composition on the denaturing gradient gel (2(nd) D). The sequence information of interested T-RFs on 2D gels can be obtained through serial poly(A) tailing reaction, PCR amplification and subsequent DNA sequencing. By employing the T-RFs-2D method, bacteria with MspI digested T-RF size of 436 (±1) bp and 514 (±1) bp were identified to be a Lysobacter sp. and a Dehalococcoides sp. in a polychlorinated biphenyl (PCB) dechlorinating culture. With the high resolution of 2D separation, T-RFs-2D separated 63 DNA fragments in a complex river-sediment microbial community, while traditional DGGE detected only 41 DNA fragments in the same sample. In all, T-RFs-2D has its advantage in obtaining sequence information of interested T-RFs and also in characterization of complex microbial communities.     

Sex-associated difference in estrogen receptor β expression in N-methyl-N'-nitro-N-nitrosoguanidine-induced gastric cancers in rats

Epidemiologic studies indicate that the incidence of gastric cancer is higher in males than in females. Although the mechanisms mediating this difference are unclear, a role for estrogens has been proposed. We used Western blotting to evaluate the role of estrogen receptor (ER) subtypes ERα and ERβ and proliferating cell nuclear antigen (PCNA) in N-methyl-N'-nitro-N-nitrosoguanidine (MNNG)-induced gastric carcinogenesis in Wistar rats; ERα and ERβ mRNA levels also were analyzed by quantitative real-time RT-PCR analysis. The incidence of gastric cancer was significantly higher in male than female rats. In both sexes, ERα expression was similar in MNNG-treated cancerous and noncancerous tissues and normal gastric tissue. However, ERβ expression in MNNG-treated cancerous and noncancerous tissues was significantly lower in male rats and higher in female rats than that in normal gastric tissue; MNNG-induced cancerous tissue showed the highest ERβ expression. PCNA expression in MNNG-treated cancerous tissues was higher than that in noncancerous tissues, and was higher in male rats than female rats. Western blotting results were consistent with the mRNA changes determined by quantitative real-time RT-PCR. The present study provides evidence of a sex-associated difference in ERβ and PCNA expression in MNNG-induced gastric cancers in Wistar rats.     

T-RFLP combined with principal component analysis and 16S rRNA gene sequencing: an effective strategy for comparison of fecal microbiota in infants of different ages

The fecal microbiota of two healthy Swedish infants was monitored over time by terminal restriction fragment length polymorphism (T-RFLP) analysis of amplified 16S rRNA genes. Principal component analysis (PCA) of the T-RFLP profiles revealed that the fecal flora in both infants was quite stable during breast-feeding and a major change occurred after weaning. The two infants had different sets of microbiota at all sampling time points. 16S rDNA clone libraries were constructed and the predominant terminal restriction fragments (T-RFs) were identified by comparing T-RFLP patterns in the fecal community with that of corresponding 16S rDNA clones. Sequence analysis indicated that the infants were initially colonized mostly by members of Enterobacteriaceae, Veillonella, Enterococcus, Streptococcus, Staphylococcus and Bacteroides. The members of Enterobacteriaceae and Bacteroides were predominant during breast-feeding in both infants. However, Enterobacteriaceae decreased while members of clostridia increased after weaning. T-RFLP in combination with PCA and 16S rRNA gene sequencing was shown to be an effective strategy for comparing fecal microbiota in infants and pointing out the major changes.     

Gut microbiota in patients after surgical treatment for colorectal cancer

Colorectal cancer (CRC) is a common disease worldwide that is strongly associated with the gut microbiota. However, little is known regarding the gut microbiota after surgical treatment. 16S rRNA gene sequencing was used to evaluate differences in gut microbiota among colorectal adenoma patients, CRC patients, CRC postoperative patients and healthy controls by comparing gut microbiota diversity, overall composition and taxonomic signature abundance. The gut microbiota of CRC patients, adenoma patients and healthy controls developed in accordance with the adenoma-carcinoma sequence, with impressive shifts in the gut microbiota before or during the development of CRC. The gut microbiota of postoperative patients and CRC patients differed significantly. Subdividing CRC postoperative patients according to the presence or absence of newly developed adenoma which based on the colonoscopy findings revealed that the gut microbiota of newly developed adenoma patients differed significantly from that of clean intestine patients and was more similar to the gut microbiota of carcinoma patients than to the gut microbiota of healthy controls. The alterations of the gut microbiota between the two groups of postoperative patients corresponded to CRC prognosis. More importantly, we used the different gut microbiota as biomarkers to distinguish postoperative patients with or without newly developed adenoma, achieving an AUC value of 0.72. These insights on the changes in the gut microbiota of CRC patients after surgical treatment may allow the use of the microbiota as non-invasive biomarkers for the diagnosis of newly developed adenomas and to help prevent cancer recurrence in postoperative patients.     

Proteomic analysis of cancer tissues: shedding light on carcinogenesis and possible biomarkers

Lung, gastric, colorectal, pancreatic, and esophageal cancers, as well as hepatocellular carcinoma (HCC), were the six most common and highly fatal cancers for Japanese men in Japan in 2003, while for women uterine cervical cancer could also be added to this list. To identify diagnostic or therapeutic biomarkers for these cancers, investigators are nowadays performing proteomic analyses of cancer tissues and cells, and revealing a large number of molecules which are diagnostic, prognostic and informative of carcinogenesis. From reports of proteomic analyses of cancerous tissues and noncancerous tissues sampled from HCC, and pancreatic, esophageal, gastric, colorectal, lung and uterine cervical cancers, we classified the proteins into digestive enzymes, growth factors, cell adhesion molecules, calcium-binding proteins, proteases, protease inhibitors, transporter proteins, structural molecules, apoptosis inhibitor, molecular chaperone, as well as proteins related to cell growth, cell differentiation, cell transformation, tumor invasion, carcinogen metabolism, and others. The aim of this study was to understand carcinogenesis of major cancers from a proteomics perspective using samples from cancer patients, and to elucidate their tumor biomarkers.     

Novel KRAS Gene Mutations in Sporadic Colorectal Cancer

Introduction

In this article, we report 7 novel KRAS gene mutations discovered while retrospectively studying the prevalence and pattern of KRAS mutations in cancerous tissue obtained from 56 Saudi sporadic colorectal cancer patients from the Eastern Province.

Methods

Genomic DNA was extracted from formalin-fixed, paraffin-embedded cancerous and noncancerous colorectal tissues. Successful and specific PCR products were then bi-directionally sequenced to detect exon 4 mutations while Mutector II Detection Kits were used for identifying mutations in codons 12, 13 and 61. The functional impact of the novel mutations was assessed using bioinformatics tools and molecular modeling.

Results

KRAS gene mutations were detected in the cancer tissue of 24 cases (42.85%). Of these, 11 had exon 4 mutations (19.64%). They harbored 8 different mutations all of which except two altered the KRAS protein amino acid sequence and all except one were novel as revealed by COSMIC database. The detected novel mutations were found to be somatic. One mutation is predicted to be benign. The remaining mutations are predicted to cause substantial changes in the protein structure. Of these, the Q150X nonsense mutation is the second truncating mutation to be reported in colorectal cancer in the literature.

Conclusions

Our discovery of novel exon 4 KRAS mutations that are, so far, unique to Saudi colorectal cancer patients may be attributed to environmental factors and/or racial/ethnic variations due to genetic differences. Alternatively, it may be related to paucity of clinical studies on mutations other than those in codons 12, 13, 61 and 146. Further KRAS testing on a large number of patients of various ethnicities, particularly beyond the most common hotspot alleles in exons 2 and 3 is needed to assess the prevalence and explore the exact prognostic and predictive significance of the discovered novel mutations as well as their possible role in colorectal carcinogenesis.