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Combining KRAS gene status with preoperative D‑dimer levels as a predictive marker of venous thromboembolism risk in patients with resectable colorectal cancer: A prospective cohort study

  • Authors:
    • Duogang Xu
    • Yulei He
    • Changkang Liao
    • Jing Tan
  • View Affiliations / Copyright

    Affiliations: Department of General Surgery, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, Yunnan 650051, P.R. China, The First School of Clinical Medicine, Yunnan University of Chinese Medicine, Kunming, Yunnan 650051, P.R. China, Department of General Surgery, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, Yunnan 650051, P.R. China
    Copyright: © Xu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 96
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    Published online on: April 22, 2024
       https://doi.org/10.3892/br.2024.1784
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Abstract

Colorectal cancer (CRC), one of the most prevalent types of cancer, is accompanied by a notably high incidence of thrombotic complications. The present study aimed to elucidate the association between KRAS mutations and hypercoagulability in operable CRC. The prognostic value of preoperative D‑dimer levels was also investigated, thus providing novel insights into the development of therapeutic strategies to enhance patient survival and diminish morbidity. Therefore, a prospective analysis of 333 CRC cases post‑surgery at Yan'an Hospital Affiliated to Kunming Medical University, between May 2019 and October 2022 was performed. Data on demographics, tumor characteristics and D‑dimer levels were compiled from the electronic health records. Venous thromboembolism (VTE) was diagnosed by doppler or computed tomography angiography, with D‑dimer thresholds set at 550 and 1,650 µg/l. KRAS mutations at codons 12 and 13 were assessed in a subset of 56 cases. Subsequently, the factors affecting the hypercoagulable state in these patients were prospectively analyzed, focusing on the pivotal role of KRAS. The results showed that KRAS mutations were associated with elevated preoperative D‑dimer levels, with 1,076 µg/l compared with 485 µg/l in the wild‑type cohort, indicative of a hypercoagulable state. Increased D‑dimer levels were also associated with vascular invasion, distant metastases and a heightened risk of postoperative VTE. Furthermore, multivariate analyses identified KRAS mutations, distant metastases and vascular invasion as independent predictors of elevated D‑dimer levels, with relative risk values of 2.912, 1.884 and 1.525, respectively. Conversely, sex, age, tumor location, differentiation grade, Ki67 index and tumor stage could not significantly affect D‑dimer levels, thus indicating a complex interplay between tumor genetics and coagulation dysfunction in CRC. The current study suggested that the KRAS mutation status, distant metastasis and vascular invasion could be considered as independent risk factors of blood hypercoagulability in patients with CRC, potentially serving as prognostic factors for VTE risk.
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Copy and paste a formatted citation
Spandidos Publications style
Xu D, He Y, Liao C and Tan J: Combining <em>KRAS</em> gene status with preoperative D‑dimer levels as a predictive marker of venous thromboembolism risk in patients with resectable colorectal cancer: A prospective cohort study. Biomed Rep 20: 96, 2024.
APA
Xu, D., He, Y., Liao, C., & Tan, J. (2024). Combining <em>KRAS</em> gene status with preoperative D‑dimer levels as a predictive marker of venous thromboembolism risk in patients with resectable colorectal cancer: A prospective cohort study. Biomedical Reports, 20, 96. https://doi.org/10.3892/br.2024.1784
MLA
Xu, D., He, Y., Liao, C., Tan, J."Combining <em>KRAS</em> gene status with preoperative D‑dimer levels as a predictive marker of venous thromboembolism risk in patients with resectable colorectal cancer: A prospective cohort study". Biomedical Reports 20.6 (2024): 96.
Chicago
Xu, D., He, Y., Liao, C., Tan, J."Combining <em>KRAS</em> gene status with preoperative D‑dimer levels as a predictive marker of venous thromboembolism risk in patients with resectable colorectal cancer: A prospective cohort study". Biomedical Reports 20, no. 6 (2024): 96. https://doi.org/10.3892/br.2024.1784
Copy and paste a formatted citation
x
Spandidos Publications style
Xu D, He Y, Liao C and Tan J: Combining <em>KRAS</em> gene status with preoperative D‑dimer levels as a predictive marker of venous thromboembolism risk in patients with resectable colorectal cancer: A prospective cohort study. Biomed Rep 20: 96, 2024.
APA
Xu, D., He, Y., Liao, C., & Tan, J. (2024). Combining <em>KRAS</em> gene status with preoperative D‑dimer levels as a predictive marker of venous thromboembolism risk in patients with resectable colorectal cancer: A prospective cohort study. Biomedical Reports, 20, 96. https://doi.org/10.3892/br.2024.1784
MLA
Xu, D., He, Y., Liao, C., Tan, J."Combining <em>KRAS</em> gene status with preoperative D‑dimer levels as a predictive marker of venous thromboembolism risk in patients with resectable colorectal cancer: A prospective cohort study". Biomedical Reports 20.6 (2024): 96.
Chicago
Xu, D., He, Y., Liao, C., Tan, J."Combining <em>KRAS</em> gene status with preoperative D‑dimer levels as a predictive marker of venous thromboembolism risk in patients with resectable colorectal cancer: A prospective cohort study". Biomedical Reports 20, no. 6 (2024): 96. https://doi.org/10.3892/br.2024.1784
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