Criteria of Li et al for Testing for BRAF Mutations in a Colorectal Cancer

Description

Li et al identified findings seen in a patient with BRAF mutations. These can help to identify those patients who should or should not undergo testing for the mutations. The authors are from the University of Western Australia, Kanazawa University (Japan), Institute of Medical and Veterinary Science (Australia) and Royal Adelaide Hospital (Australia).

BRAF is a member of the RAF family of serine/threonine kinases. The V600E mutation is the most common in colorectal cancer..

BRAF mutations are more common with:

(1) CpG island methylator phenotype (CIMP) positive

(2) MLH1 positive

(3) MSI positive (except if HNPCC-related)

(4) carcinomas arising from large serrated adenomas (hyperplastic polyps)

(5) carcinomas arising in the proximal colon

Histologic features associated with BRAF mutations (shared with HNPCC, see 27.15.25):

(1) infiltrating lymphocytes

(2) poorly differentiated

(3) mucinous differentiation

People unlikely to have a BRAF mutation:

(1) KRAS mutation positive

(2) CIMP negative

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Description

Specialty

ICD-10