胰腺癌患者外周血与肿瘤组织中KRAS基因突变的研究

目的检测胰腺癌患者外周血与肿瘤组织KRAS基因突变率及两者的一致性,探讨外周血KRAS基因突变的临床应用价值。方法收集2011年7月至2012年11月北京军区总医院、北京恒兴医院30例住院胰腺癌患者外周血标本,同时在北京军区总医院、北京恒兴医院、空军总医院、解放军309医院收集胰腺癌石蜡标本25例,胰腺癌新鲜组织5例。利用高分辨率熔解曲线(HRM)法分别检测30例胰腺癌患者外周血和30例肿瘤组织中的KRAS基因突变情况,分析其中13例外周血与肿瘤组织配对标本基因突变的一致性。结果胰腺癌患者外周血中KRAS基因突变率为50%,肿瘤组织为70%,配对标本中突变一致性为62.5%,差异有统计学意义(P<0.05)。结论胰腺癌患者外周血与肿瘤组织KRAS基因突变一致性较高,在无法获得组织学标本时可以用高敏感性HRM法检测外周血KRAS基因状态,为胰腺癌的临床诊疗提供帮助。

KRAS Gene Mutation in Tumor Tissue and Peripheral Blood of Pancreatic Cancer Patients

Objective To detect the consistency of the KRAS gene mutation in peripheral blood and tumor tissue of patients with pancreatic cancer and discuss the clinical application value of KRAS mutation in peripheral blood. Methods During Jul. 2011 and Nov. 2012 from Beijing Military General Hospital, Beijing Hengxing Hospital ,30 pancreatic cancer specimens of the hospitalized patients were collected, and 25 pancre- atic paraffin and 5 fresh pancreatic tissue specimen were collected from Beijing Military General Hospital, Beijing Hengxing hospitals, Air Force General Hospital, PLA 309 Hospital during the same period. High reso- lution melting（HRM） was used to detect KRAS mutations in 30 peripheral blood and 30 tumor tissue of patients with pancreatic cancer. The consistency of the KRAS gene mutation of peripheral blood-tumor tis- suein 13 cases was analyzed. Results The KRAS gene mutation rate was 50% in peripheral blood of patients with pancreatic cancer, and was 70% in cancer tissue, the mutation consistency was 62.5% in peripheral blood-tumor tissue matched samples. The difference was statistically significant（ P 〈 0.05 ）. Con- clusion The consistency of the KRAS gene mutation in peripheral blood and tissue is high. KRAS mutations of peripheral blood by HRM could be used for clinical diagnosis and treatment in cases when tissue specimen is hard to get.