胰液K-ras密码子点突变联合血清CA 199水平与胰腺癌复发关系的研究

目的探讨胰液中K-ras 12密码子点突变联合血清CA199检测与胰腺癌病程的关系。方法测定32例临床及手术证实的胰腺癌患者血清CA199水平,并采用内镜ERCP从胰管收集的胰液标本,聚合酶链反应-限制性片段长度多态性分析(PCR-RFLP)检测胰液K-ras 12基因12密码子点突变,分析胰液中K-ras 12密码子点突变及血清CA199联合检测与胰腺癌术后复发的关系。结果(1)胰液中K-ras 12密码子点突变率为56.3%,与肿瘤大小密切相关(P<0.05)。K-ras 12密码子点突变阳性、阴性表达病例3年复发率分别为66.7%和33.3%。(2)高血清CA199水平且K-ras 12密码子点突变阳性病例组3年复发率为69.2%,而低血清CA199且ras阳性病例组3年复发率为20.0%,差异显著(P<0.05)。结论联合胰液中K-ras 12密码子点突变及血清CA199检测可作为判断胰腺癌术后复发的有效指标,多因素分析对胰腺癌术后复发的判断更有价值。

Observation on the Relationship Between K-ras Mutation in Pancreatic Jucice Accompanying by Serum CA 199 Level and Recurrance of Pancreatic Carcinoma

Objective To study the relationship between K-ras mutation in pancreatic juice accompanying by serum CA 199 level and recurrence of pancreatic carcinoma.Methods K-ras point mutation was detected using the polymerase chain reaction and restriction fragment-length polymorphism(PCR-RFLP)in pure pancreatic juice(PPJ),which were collected from the pancreatic duct under endoscopic retrograde clolangio-pancreatic tography(ERCP).And serum CA 199 level were examined in 32 patients with pancreatic carcinoma.The relationships between K-ras,serum CA 199 level and recurrence rate were analyzed.Results(1)The positivity of K-ras point mutation in PPJ was 56.3%;The positivity of K-ras point mutation in PPJ correlated with tumors currence rate(P<0.05).(2)The recurrence rate in high-serum CA 199 level group with positive K-ras point mutation in PPJ was 69.2%,while in hypo-serum CA 199 level was 20.0%(P<0.05).Conclusion K-ras mutation in pancreatic juice and serum CA 199 level are effective in dictators for recurrence and prognosis of pancreatic carcinoma.The analysis of muliti-gene is more valuable than that of single.