血浆K-ras突变联合CA19-9检测对胰腺癌的诊断价值

目的：探讨血浆K－ras基因突变联合CA19－9检测对胰腺癌的诊断价值。方法：对连续58例疑为胰腺肿瘤患者，入院时抽取外周静脉血，分离血浆并提取DNA。采用突变富集PCR－RFLP法分析K－ras基因密码子12突变，用放射免疫法测定血清CA19－9，所有病例的血标本分析均在术前完成，并将检测结果与手术探查，病理诊断进行比较。结果：41例胰腺癌患者中，血浆K-ras基因突变者29例（占70．7％），血清CA19－9升高者30例（占73．2％），联合K－ras与CA19－9检测胰腺癌的敏感性为90．2％（37／41），在其他17例非胰腺癌患者中，有3例血浆K－ras突变，8例血清CA19－9有升高，结论：血浆K－ras突变可能是诊断胰腺癌的一个有价值的指标，若同时测定血清CA19－9，可提高检测胰腺癌的敏感性。

Study on the diagnostic value of plasma K-ras mutation combined serum CA19-9 in patients with pancreatic carcinoma

Objective:To investigate the diagnostic value of detection of plasma K ras mutation combined serum CA19 9 in patients with pancreatic carcinoma.Methods:Fifty eight consecutive patients who were suspected of pancreatic masses were included in the study. Peripheral venous blood samples were obtained in heparinized tubes at admission. Plasma was isolated. K ras mutation in DNA extracted from plasma was analyzed using the mutation enriched polymerase chain reaction restriction fragment length polymorphism technique. Serum CA19 9 was determined by radioimmunoassays. The above analyses were all performed before operation. The results were compared to surgical findings and pathological diagnosis.Results:In 41 patients with pancreatic carcinoma,the mutated K ras in plasma and elevated CA19 9 in serum were found in 29 and 30 patients,respectively. K ras combined with CA19 9,90.2%(37/41) was tested positive. Mutated K ras and elevated CA19 9 were also detected in the peripheral venous blood samples in 3 and 8 patients without pancreatic carcinomas,respectively.Conclusion:These results suggest that K ras mutation in plasma may be a potential tumor marker for pancreatic carcinoma in patients with pancreatic lesion. When combined with CA19 9,the sensitivity is increased. This method is rapid and noninvasive. Thus,we suggest the use of plasma K ras mutation analysis in conjunction with CA19 9 as a diagnostic approach for detection of pancreatic carcinoma.