title: Concordance in KRAS and BRAF mutations in endoscopic biopsy samples and resection specimens of colorectal adenocarcinoma.
abstract: BACKGROUND
  KRAS testing is mandatory if anti-EGFR therapy is considered in patients with metastatic colorectal cancer (CRC). In addition, BRAF mutations seem to be an important negative prognostic factor. The aim of this study is to establish the concordance of KRAS and BRAF mutational status in paired biopsy and resection specimens of primary CRC using several analytic methods.
  
  
  METHODS
  DNA was extracted from paraffin blocks of 126 CRC patients. KRAS codon 12/13 and BRAF V600E mutational status was assessed using high resolution melting (HRM), direct sequencing (DS) of the HRM polymerase chain reaction (PCR) product. In addition, the Therascreen Amplification Refractory Mutation System (ARMS)-Scorpion KRAS assay and BRAF pyrosequencing were employed; both assays claim to require less tumour cells in comparison with DS.
  
  
  RESULTS
  KRAS and BRAF were found to be mutually exclusive. Mutation frequencies were 33.9% for KRAS, and for BRAF 19.0%, respectively. Concordance of KRAS mutational status between biopsy and resection specimens was 97.4% (ARMS), 98.4% (DS) and 99.2% (HRM), respectively. For BRAF concordance was 98.4% (Pyro, DS) and 99.2% (HRM).
  
  
  CONCLUSIONS
  KRAS and BRAF mutational status of endoscopic biopsies and resection specimens of CRC showed a >95% concordance. Endoscopic biopsies can be confidently used for molecular analysis.
authors.affiliation: Department of Pathology, Isala Klinieken, Zwolle, The Netherlands.
authors.forename: L C
authors.initials: LC
authors.lastname: Krol
authors.forename: N A
authors.initials: NA
authors.lastname: 't Hart
authors.forename: N
authors.initials: N
authors.lastname: Methorst
authors.forename: A J
authors.initials: AJ
authors.lastname: Knol
authors.forename: C
authors.initials: C
authors.lastname: Prinsen
authors.forename: J E
authors.initials: JE
authors.lastname: Boers
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics* / Q000601:surgery; D000368:Aged; D001706:Biopsy; D015179:Colorectal Neoplasms / Q000235:genetics* / Q000601:surgery; D004724:Endoscopy; D005260:Female; D011905:Genes, ras; D006801:Humans; D008297:Male; D009154:Mutation; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics*
chemical_list: C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf