NRAS (neuroblastoma RAS viral [v-ras] oncogene homolog) (eg, colorectal carcinoma), gene analysis, variants in exon 2 (eg, codons 12 and 13) and exon 3 (eg, codon 61)
CPT4 code
Name of the Procedure:
NRAS (Neuroblastoma RAS viral [v-ras] oncogene homolog) Gene Analysis, Variants in Exon 2 (Codons 12 and 13) and Exon 3 (Codon 61)
Summary
NRAS gene analysis is a genetic test conducted to detect mutations in specific regions of the NRAS gene, particularly in codons 12 and 13 of exon 2 and codon 61 of exon 3. These mutations are associated with various cancers, including colorectal carcinoma.
Purpose
This test is used to identify mutations in the NRAS gene that may contribute to the development and progression of colorectal carcinoma and other types of cancer. The findings can guide treatment decisions, including suitability for targeted therapies.
Indications
- Patients with diagnosed colorectal carcinoma.
- Individuals with a family history of colorectal carcinoma or other cancers involving NRAS mutations.
- Cases where genetic profiling of a tumor is necessary for personalized treatment planning.
Preparation
- No special preparation such as fasting or medication adjustment is typically required.
- A detailed medical history and possibly other diagnostic imaging or tests may be necessary beforehand.
Procedure Description
- Sample Collection: A small sample of tumor tissue or blood is collected.
- DNA Extraction: DNA is extracted from the collected sample.
- PCR Amplification: Specific regions of the NRAS gene are amplified using polymerase chain reaction (PCR).
- Sequencing: The amplified DNA is sequenced and analyzed to identify mutations in the specified codons of exon 2 and exon 3.
Duration
The entire process, from sample collection to results, typically takes 1-2 weeks. The actual sample collection procedure takes only a few minutes.
Setting
The sample is collected in an outpatient clinic or hospital setting. The analysis is conducted in a specialized laboratory.
Personnel
- Oncologist
- Pathologist
- Medical laboratory technician or geneticist
Risks and Complications
- Mild discomfort or bruising at the sample collection site.
- Rarely, false positives or negatives that may require further testing.
Benefits
- Identifying NRAS mutations can help guide the choice of targeted therapies.
- Provides a more personalized approach to cancer treatment.
- Helps predict the course and prognosis of the disease.
Recovery
- Very minimal recovery is needed.
- Patients can resume normal activities immediately after sample collection.
Alternatives
- Other gene analysis tests, such as KRAS or BRAF gene mutations.
- Comprehensive tumor genetic profiling.
- Traditional cancer treatments without genetic analysis, though possibly less targeted.
Patient Experience
- During the procedure, patients might experience minor discomfort from the sample collection (e.g., a blood draw or biopsy).
- Results will be discussed in a follow-up appointment with the healthcare provider.
Pain management and comfort measures are usually unnecessary due to the minimally invasive nature of sample collection.