胰管刷检标本K-ras基因突变检测在胰腺癌诊断中的作用

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链反应(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1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100％.20例胰腺癌中14例检测到K-ras突变,7例慢性胰腺炎1例K-ras突变,两组间差异显著(P<0.05).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、准确性分别为70％、94％、83％.结论:检测胰管刷检标本中K-ras基因突变有助于提高胰腺癌的诊断,具有良好的临床应用前景.

Detection of K-ras gene codon 12 mutation from pancreatic duct brushings in diagnosis of pancreatic cancer

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