Tumor Biology

, Volume 35, Issue 7, pp 7163–7175 | Cite as

Implication of K-ras and p53 in colorectal cancer carcinogenesis in Tunisian population cohort

  • Chaar Ines
  • Ounissi Donia
  • Boughriba Rahma
  • Azza Ben Ammar
  • Amara Sameh
  • Taher Khalfallah
  • Ben hmida Abdelmajid
  • Mzabi Sabeh
  • Bouraoui Saadia
Research Article


According to the multistep route of genetic alterations in the colorectal adenoma–carcinoma sequence, the complex K-ras/p53 mutation is one of the first alterations to occur and represent an important genetic event in colorectal cancer (CRC). An evaluation of the mutation spectra in K-ras and p53 gene was effected in 167 Tunisian patients with sporadic CRC to determine whether our populations have similar pattern of genetic alteration as in Maghrebin’s population. Mutation patterns of codon 12–13 of K-ras and exon 5–8 of p53 were analyzed by immunohistochemistry and PCR-SSCP and confirmed by sequencing. Mutations in the K-ras gene were detected in 31.13 % and affect the women more than the men (p = 0.008). Immunostaining showed that expression of p21 ras was correlated with the advanced age (p = 0.004), whereas loss of signal was associated with mucinous histotype (p = 0.003). Kaplan–Meier survival curve found that patients with the K-ras mutation had a shorter survival compared with patients without mutation (p = 0.005). Alteration in p53 was seen in 17.4 % of patients and affects three hot spot codons such as 175, 245, and 248. Overexpression of p53 was seen in 34.1 % and correlated with tumor node metastasis (TNM) advanced stage (p = 0.037) and mucinous histotype (p = 0.001). A high concordance between p53 expression and alteration (p < 0.005) was shown. Concomitant mutations in K-ras and p53 gene were detected in only 4 % of tumors. K-ras and p53 undergo separate pathways in colorectal tumorogenesis. Interestingly, mutations in the K-ras gene might be considered a valuable prognostic factor correlated to poor outcome. p53 gene alterations were rather low in our set, and methylation pattern of p53 is required to elucidate the molecular basis of this protein in CRC.


K-ras and p53 Immunohistochemistry Sequencing Prognosis Colorectal cancer 



The authors thank the Ministry of Health and Scientific Research for the support of this study.

Conflicts of interest



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Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2014

Authors and Affiliations

  • Chaar Ines
    • 1
    • 4
    • 5
  • Ounissi Donia
    • 1
    • 4
    • 5
  • Boughriba Rahma
    • 1
    • 4
    • 5
  • Azza Ben Ammar
    • 1
    • 4
    • 5
  • Amara Sameh
    • 1
    • 4
    • 5
  • Taher Khalfallah
    • 1
    • 3
    • 5
  • Ben hmida Abdelmajid
    • 3
    • 4
    • 5
  • Mzabi Sabeh
    • 1
    • 2
    • 4
    • 5
  • Bouraoui Saadia
    • 1
    • 2
    • 4
    • 5
  1. 1.Laboratory of Colorectal Cancer Research UR03ES04Science University TunisTunisTunisia
  2. 2.Department of Pathology and CytologyMongi Slim Hospital La MarsaTunisTunisia
  3. 3.Department of Epidemiology and Preventive MedicineMedicine University of TunisTunisTunisia
  4. 4.Department of General SurgeryMongi Slim Hospital La MarsaTunisTunisia
  5. 5.Science University of Tunis UTMTunisTunisia

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