Journal of Biotechnology & Biomaterials
Open Access

Abstract

Purpose: To establish the differential molecular and clinicopathological risk and prognosis of colorectal cancers from Middle Eastern patients. A large cohort of Saudi colorectal tumors was classified molecularly into traditional, alternate and serrated pathway. Patients & Methods: Retrospective study where more than 700 patients were evaluated for clinicopathological criteria and molecular markers such as microsatellite instability (MSI) using PCR, DNA methylation analysis for CIMP and mutational analysis for KRAS & BRAF. Results: The most common is traditional pathway which accounts for 33.4% of CRC cases and shows MSS, CIMP negative, BRAF negative and KRAS negative. The least common is serrated pathway which accounts for only 0.8% of cases and comprise of CIMP positive, BRAF positive, KRAS negative and any MSI. 54.2% CRC cases did not qualify to fit into any pathway and thus were designated as an unassigned group. Interestingly none of these pathways has correlation with overall survival, however one molecular group comprising of MSS/low, CIMP negative, BRAF negative and KRAS positive cases tend to have poor prognosis (p=0.0079). Conclusion: This study establishes the differential clinicopathological risk and prognosis for different integrated pathways in Saudi colorectal cancers. Serrated pathway accounts for a very low proportion of CRC patients. The unassigned group that accounted for the majority of our cases reflects the heterogeneity of colorectal cancers. This study warrants the need to unravel the molecular genetic basis of this disease and to further subcategorize these CRC cases into different pathways for better understanding of disease pathogenesis for providing specific pathway based therapeutic management.

Biography

Khawla S Al-Kuraya is a Distinguished Physician-Scientist and the Director of the Research Centre at King Fahad National Centre for Children’s Cancer, King Faisal Specialist Hospital and Research (KFSH) in Riyadh, Saudi Arabia. After receiving her Medical degree from King Saud University School of Medicine in Riyadh, Saudi Arabia, she completed her Residency and Fellowship in Pathology at Georgetown University Hospital in Washington DC. She is an Author of over 100 original research articles, editorials, review articles and book chapters. Her professional memberships include the American Association for Cancer Research, College of American Pathologist and The American Society of Human Genetic. She is also on the Executive Committee of ICGC.

Email: kkuraya@kfshrc.edu.sa