The prognostic role of microsatellite instability, codon-specific KRAS, and BRAF mutations in colon cancer

Chun Chi Lin, Jen Kou Lin, Tzu Chen Lin, Wei Shone Chen, Shung Haur Yang, Huann Sheng Wang, Yuan Tzu Lan, Jeng Kai Jiang, Muh Hwa Yang, Shih Ching Chang*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


Background This study aimed to establish a correlation between MSI, KRAS mutations, and BRAFV600E in colon cancer and to investigate the prognostic effect. Methods Colon cancer patients who underwent surgical intervention were enrolled. MSI status was identified by genotyping, and the mutational statuses of KRAS and BRAF were determined by MassARRAY, targeting 22 mutations. The clinicopathological differences and correlations between these factors were analyzed. Results Among 1,063 patients, tumors with MSI-H were significantly associated with BRAFV600E (P = 0.001). KRAS and BRAF mutations were mutually exclusive (P = 0.001). Patients with MSI-H tumors had significantly improved overall survival compared with patients that had microsatellite instability-low/stable (MSI-L/MSS) tumors (hazard ratio 0.686: 95% confidence interval: 0.479-1.162, P = 0.040). In addition, the BRAF V600E mutation was a poor prognostic factor in tumors with MSI-L/MSS (P = 0.020). KRAS mutations were not prognostic factors, but sub-group analysis demonstrated that mutations in KRAS codon 12 were associated with significantly worse survival than wild-type KRAS, mutations in KRAS codon 13, or mutations elsewhere. Conclusions MSI and the BRAFV600E mutation have a prognostic impact in colon cancer. Variable KRAS mutations may have different effects on colon cancers; further studies are needed to verify these results.

Original languageEnglish
Pages (from-to)451-457
Number of pages7
JournalJournal of Surgical Oncology
Issue number4
StatePublished - Sep 2014


  • BRAF mutation
  • KRAS mutation
  • colon cancer
  • microsatellite instability
  • prognosis


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