Analysis of BRAF V600E in Precancerous and Cancerous Lesions of Colorectum by Immunohistochemistry: A Research Protocol

Abstract

Introduction: Colorectal cancers have been extensively studied in recent years to understand their molecular abnormalities and their impact on treatment outcomes, as they continue to be a major global health burden. The Adenomatous Polyposis Coli (APC) β-catenin pathway and the Mitogen-activated Protein Kinase (MAPKs) pathway are the topic of extensive research in colorectal pathology. Need of the study: The mutation in B-type Rapidly Accelerated Fibrosarcoma (BRAF) kinase is known to be associated with the pathogenesis and progression of precancerous lesions to cancerous lesions. Precancerous lesions carry a high risk of developing Adenocarcinoma. Therefore, the expression of BRAF can serve as a useful predictive and prognostic biomarker for disease outcomes and establish correlations with other clinicopathological parameters. Aim: The present study aims to assess the immunoexpression of BRAF V600E in precancerous and cancerous lesions of the colorectum, as well as the relationship between BRAF expression, histological grading, and the Tumour, Lymph Nodes, and Metastasis (TNM) staging of colorectal cancers. Materials and Methods: This will be an ambispective observational study (both prospective and retrospective) conducted at the Department of Pathology, Rural Hospital, Wardha, Maharashtra, India, over a two-year period (Retrospective data: August 2021 to July 2022, Prospective data: August 2022 to July 2023). A total of 25 cases each of precancerous and cancerous colorectal lesions will be included. Immunohistochemical expression of BRAF V600E will be performed on tissue sections from each case, and scoring will be conducted. The relationship between BRAF expression and clinicopathological parameters (such as tumour site, tumour size, number of positive lymph nodes, and perineural invasion), histological grade, and TNM stage will be assessed. The results will be analysed using Statistical Package for the Social Sciences (SPSS) software, version 27.0. The Chi-square test will be used to investigate the relationship and association between BRAF V600E expression and clinicopathological parameters. Furthermore, Pearson’s correlation coefficient method will be utilised to determine the correlation between two parameters. A significance level of 95% (p-value < 0.05) will be considered.