Independent prognostic value of KRAS mutation in resected colorectal cancer based on multi-gene sequencing

Figure 1 Prognostic analysis of genetic mutations in colorectal cancer. This flowchart outlines the study design for the prognostic analysis of genetic mutations in 87 colorectal cancer cases. The process begins with patient cohort selection, followed by next-generation sequencing detection of mutations in the KRAS, PIK3CA, FBXW7, and TP53 genes. Subsequent steps include clinicopathological correlation analysis and survival analysis using Kaplan-Meier and Cox regression methods. The main findings demonstrate that KRAS mutation is an independent predictor of poor prognosis with an allele-specific impact, while PIK3CA, FBXW7, and TP53 mutations show limited or no independent prognostic value in this cohort. CRC: Colorectal cancer; HR: Hazard ratio; NGS: Next-generation sequencing.

Figure 2 Co-occurrence matrix of KRAS, PIK3CA, FBXW7, and TP53 genetic mutations. The heatmap illustrates the frequency of co-occurring mutations between the genes listed on the Y-axis and X-axis. The color intensity in each cell corresponds to the number of patients harboring mutations in both genes, as indicated by the scale bar (range: 0-12). Key observations include a strong co-occurrence between TP53 and FBXW7 mutations (12 patients), and between TP53 and KRAS mutations (8 patients). KRAS and PIK3CA mutations co-occurred in 4 patients. No patients had mutations in FBXW7 and KRAS, or FBXW7 and PIK3CA. Self-comparisons are zero by definition.

Figure 3 Overall survival by KRAS, PIK3CA, FBXW7 and TP53 status. A: Overall survival (OS) by KRAS status. Log-rank P = 0.012. Hazard ratio (HR) (mutant vs wild-type) from Cox model: 3.57 (95%CI: 1.85-6.89); B: OS by PIK3CA status. Log-rank P = 0.027. HR (mutant vs wild-type) from Cox model: 0.26 (95%CI: 0.09-0.74); C: OS by FBXW7 status. Log-rank P = 0.213. HR (mutant vs wild-type) from Cox model: 1.86 (95%CI: 0.85-4.05); D: OS by TP53 status. Log-rank P = 0.340. HR (mutant vs wild-type) from Cox model: 1.68 (95%CI: 0.87-3.25).