胰管刷检标本K-ras基因突变检测在胰腺癌诊断中的价值

The diagnostic value of detecting K-ras gene codon 12 mutations by pancreatic duct brushings for pancreatic cancer

目的 探讨胰管刷检标本K ras基因突变检测在胰腺癌诊断中的价值。方法 应用突变富集聚合酶联反应 (PCR) 单链构象多态性 (SSCP)法 ,检测胰腺疾病胰管刷检标本K ras基因第一外显子第 12密码子点突变。结果 35例胰管刷检标本PCR扩增均获成功 ,成功率为 10 0 %。 2 0例胰腺癌中 14例K ras突变 (70 % ) ,7例慢性胰腺炎中 1例K ras突变 (14 % ) ,两组间差异有显著性 (P <0 .0 5 )。胰腺囊腺瘤、十二指肠乳头癌均未见K ras突变。胰管刷检标本K ras突变与胰腺癌部位无关。胰管刷检K ras突变检测诊断胰腺癌的敏感性、特异性和准确性分别为 70 % ,90 %和 83%。结论 检测胰管刷检标本中K ras基因突变有助于胰腺癌的诊断 。

Objective To investigate the diagnostic value of detecting K ras gene codon 12 mutations in cytologic specimens by endoscopic pancreatic duct brushing for pancreatic cancer. Methods Thirty five patients at Changhai hospital between 1999 and 2001 were enrolled. Cells from pancreatic duct burshings during ERCP were suspended with PBS. DNA of the cells was extracted and K ras gene codon 12 mutations were detected by means of PCR SSCP. Results K ras gene mutation rate of pancreatic cancer was 70%, which was higher than that of chronic pancreatitis (14%, P < 0.05 ). K ras gene mutations were not found in pancreatic cystocarcinoma and duodenum carcinoma. In terms of the location of pancreatic cancer, there was no significant difference between the head and the body as well as tail. Sensitivity, specificity, and accuracy of this method for the diagnosis of pancreatic cancer were 70%, 94%, and 83% respectively. Conclusions K ras mutation analysis performed on pancreatic brushing samples is an efficient procedure and it helps to diagnose pancreatic cancer.