胰液K-ras12密码子点突变联合胰液CA19-9水平与胰腺癌的复发关系

Observation on the Relationship between K-ras Mutation in Pancreatic Juice Accompanying by CA19-9 Level and Recurrence of Pancreatic Carcinoma

目的:探讨胰液中K-ras12基因密码子点突变和胰液CA19-9水平与胰腺癌术后复发的关系。方法:采用内镜ERCP从胰管收集的胰液标本,测定48例临床及手术证实的胰腺癌患者胰液CA19-9水平,并采用聚合酶链反应-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密码子点突变及胰液CA19-9水平与胰腺癌术后复发的关系。结果:(1)胰液中K-ras12密码子点突变率为54.17%,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61.90%和38.10%。(2)胰液CA19-9高水平且K-ras12密码子点突变阳性组3年复发率为62.5%,而胰液CA19-9低水平且K-ras12密码子点突变阳性组3年复发率为30.0%,两者有显著差异检测(P<0.05)。结论:联合胰液中K-ras12密码子点突变和胰液CA19-9水平可作为判断胰腺癌术后复发的有效指标,多因素分析对判断胰腺癌术后复发更有价值。

Objective：To study the relationship between K-ras mutation in pancreatic juice accompanying by CA19-9 level and recurrence of pancreatic carcinoma.Methods：K-ras point mutation was detected using the polymerase chain reaction and restriction fragment-length polymorphism（PCR-RFLP） in pure pancreatic juice（PPJ）,which were collected from the pancreatic togarphy（ERCP）.And CA19-9 levels were examined in 32 patients with pancreatic carcinoma.The relationships between K-ras and CA19-9 level and recurrence rate were analyzed.Results：（l） The positivity of K-ras point mutation in PPJ was 54.17%,the positivity of K-ras point mutation in PPJ correlated with tumor recurrence rate（P〈0.05）.（2） The recurrence rate in high CA19-9 level group with positive K-ras point mutation in PPJ was 62.50%,while in hypo CA19-9 level was 30.0%,（P〈0.05）.Conclusion：K-ras mutation in pancreatic juice and CA19-9 level are effective in dictators for recurrence and prognosis of pancreatic carcinoma.The analysis of multi-gene is more valuable than that of single.