外周血K-ras基因突变和CA19-9的联合检测在胰腺癌诊断中的作用

目的 研究K-ras基因突变和CA19-9联合检测在胰腺癌诊断中的作用。方法 选择同期的15例胰腺癌和33非胰腺癌病人,同时行外周血K-ras基因突变和CA19-9的检测,利用统计学方法进行数据分析。结果 外周血K-ras基因突变和CA19-9联合检测诊断胰腺癌的敏感性、特异性分别为66．67％和97％,研究组和对照组之间差异具有显著性意义(P=0．001)。结论 外周血K-ras基因突变和CA19-9的联合检测显著提高了胰腺癌诊断的特异性,弥补了单一K-ras基因突变和CA19-9检测的不足,可用于胰腺癌的辅助诊断。

Combined detection of K-ras mutation and CA 19-9 level in plasma of patients with pancreatic cancer

OBJECTIVE: To confirm the effect of combined detection of K-ras gene mutation and CA19-9 level in plasma in the diagnosis of pancreatic carcinoma. METHODS: In 33 patients without pancreatic carcinoma and 15 patients with pancreatic carcinoma, the value of K-ras mutation and CA19-9 level were examined by enriched polymerase chain reaction (PCR) restriction fragment length polymorphism (RFLP) and radioimmunoassay respectively. The data were analysed with chi(2) test, Fisher's exact test and Kruekal-wall's test. All patients were confirmed pathologically. RESULTS: Eleven of the 15 patients with pancreatic carcinoma and 2 of 10 patients with chronic pancreatitis were found K-ras mutation. CA19-9 level in patients with pancreatic cancer was significantly higher than that in those with benign disease but with a low specificity. The sensitivity, specificity of combined detection of K-ras gene mutation and CA19-9 level in the plasma of patients with pancreatic cancer were 66.67% and 97%. There was a significant difference between patients with pancreatic cancer and those without pancreatic cancer. Pathological examination showed atypical hyperplasia in one patient with chronic pancreatitis who had K-ras mutation and higher CA19-9 level. CONCLUSIONS: Combined detection of K-ras gene mutation and CA19-9 can be used for adjuvant diagnosis of pancreatic cancer. It is more specific than detection of single K-ras gene mutation or CA19-9 level in the plasma. The method is complementary to single detection of K-ras gene mutation or CA19-9 level because it decreases the rate of false-positive diagnosis.