外周血K-ras基因突变和CA19-9联合检测对胰腺癌的诊断作用

Significance of detection of K-ras gene mutations and CA19-9 in peripheral blood for diagnosis of pancreatic carcinoma

目的探讨联合检测患者外周血K-ras基因突变和血清CA19-9对胰腺癌的诊断作用。方法采用高分辨率熔解曲线(HRM)法和电化学发光免疫分析法,分别检测胰腺癌患者(25例)、胰腺非癌性患者(15例)和正常对照组(15例)外周血中,K-ras基因突变和CA19-9水平,并对结果进行统计学分析。结果胰腺癌患者外周血中,K-ras基因突变率为48.0%,胰腺非癌性病变组突变率为6.7%;CA19-9在胰腺癌组中阳性率为72.0%,胰腺非癌性病变中阳性率为13.0%。K-ras基因突变与CA19-9平行法联合检测(即两项指标中有一项为阳性即为阳性)诊断胰腺癌的敏感度和特异度分别为80.0%和80.0%。采用系列法联合检测(两项指标必须均为阳性)诊断胰腺癌的敏感度和特异度分别为40.0%和100%。15例健康对照者外周血中K-ras基因和CA19-9均无异常。结论联合检测外周血K-ras基因突变和CA19-9可以为胰腺癌的诊断提供一种敏感性、特异性高的无创性检测方法。

Objective To detect the K-ras gene mutation and CA19-9 of patients for the diagnosis of pancreatic carcinoma. Methods Using high resolution melting （HRM） method and the eleetrochemilu- minescence immunoassay, we detect the K-ras mutations and CA19-9 level of pancreatic carcinoma patients （25 cases） ,patients without pancreatic carcinoma （15 cases） and normal control group （15 cases） . The data were analysed with Fisher＇ s exact test. Results The K-ras mutation rate of patients with pancreatic carcinoma and patients without pancreatic cancer is 48.0% and 6.7% . The CA19-9 positive rate of pa- tients with pancreatic carcinoma and patients without pancreatic carcinoma are 72. 0% and 13.0%. The sensitivity and specificity of combined detection the K-ras and CA19-9 using the parallel method （two inde- xes have a positive for that is positive for） to diagnose the pancreatic carcinoma are 80.0% and 80. 0% , Those are 40. 0% and 100% when using series method （two indexes must be all positive）. The K-ras and CA19-9 of normal control group （ 15 cases） are all normal. Conclusions The combined detection of K-ras gene mutation and CA19-9 in peripheral blood from patients with pancreatic carcinoma can provide a detec- tion method with high sensitivity, specificity and noninvasive.