胰液K-ras基因突变和血清CA19-9联合检测判断胰腺癌复发

Significance of K-ras mutation in pancreatic juice and high serum CA19-9 level in predicting recurrence of pancreatic carcinoma.

目的研究胰液中K-ras12密码子点突变和血清CA19-9联合检测结果与胰腺癌病程的关系。方法测定32例临床及手术证实的胰腺癌患者血清CA19-9水平,同时采用内镜ERCP从胰管收集胰液标本,应用聚合酶链反应限制性片断长度多态性分析(PCR-RFLP)检测胰液K-ras基因12密码子点突变,分析K-ras12密码子点突变及血清CA19-9水平联合检测结果与胰腺癌临床特征和术后复发的关系。结果 (1)胰液中K-ras12密码子点突变率为56．3％,与肿瘤大小密切相关(P<0．05)。K-ras12密码子点突变阳性、阴性表达病例3年复发率分别为66．7％和33．3％。(2)高血清CA19-9水平且K-ras12密码子点突变阳性组3年复发率为69．2％,而低血清CA19-9水平且K-ras12密码子点突变阴性组3年复发率为20．0％,两组差异显著(P<0．05)。结论联合胰液中K-ras12密码子点突变和血清CA19-9检测可作为判断胰腺癌术后复发的有效指标,多因素分析对胰腺癌术后复发的判断更有价值。

Objective To assess the significance of K- ras mutation in pancreatic juice and high serum CA19 -9 level in predicting recurrence of pancreatic carcinoma. Methods K-ras point mutation was detected using polymerase chain reaction and restriction fragment length polymorphism （PCR- RFLP） in pure pancreatic juice （PPJ）collected by means of endoscopic retrograde cholangio pancreatography （ERCP）. Serum CA19- 9 levels were examined in 32 patients with pancreatic carcinoma. The relationship of K-ras and serum CA19 -9 level with the recurrence rate of pancreatic carcinoma was analyzed. Results （1）The positively of K ras point mutation in PPj was 56. 3%. bearing a correlation with the tumor recurrence rate（P〈 0,05）;（2）The recurrence rate in high-serum CA19- 9 level group with K-ras point mutation in PPj was 69. 2%, while in hypo-serum CA19-9 level was 20.0%（P〈 0.05）. Conclusions K-ras mutation in pancreatic juice and high serum CA19- 9 level are effective indictors for predicting recurrence of pancreatic carcinoma.