K-ras基因突变在胰腺肿块超声引导下细针穿刺活检诊断中的应用
K-ras gene mutation in the diagnosis of ultrasound guided fine-needle biopsy of pancreatic masses.
作者信息
Zheng Min, Liu Lian-Xin, Zhu An-Long, Qi Shu-Yi, Jiang Hong-Chi, Xiao Zhu-Ying
机构信息
Department of Ultrasound, the First Clinical College, Harbin Medical University, Harbin 150001, Heilongjiang Province, China.
出版信息
World J Gastroenterol. 2003 Jan;9(1):188-91. doi: 10.3748/wjg.v9.i1.188.
AIM
To investigate the utility of K-ras mutation analysis of ultrasound guided fine-needle aspirate biopsy of pancreatic masses.
METHODS
Sixty-six ultrasound guided fine-needle biopsies were evaluated by cytology, histology and k-ras mutation. The mutation at codon 12 of the k-ras oncogene was detected by artificial restriction fragment length polymorphisms using Bst NI approach.
RESULTS
The presence of malignant cells was reported in 40 of 54 pancreatic carcinomas and K-ras mutations were detected in 45 of the 54 FNABs of pancreatic carcinomas. The sensitivity of cytology and k-ras mutation were 74 % and 83 %, respectively. The specialty of cytology and k-ras mutation were both 100 %. The sensitivity and specialty of k-ras mutation combined with cytology were 83 % and 100 %, respectively.
CONCLUSION
High diagnostic accuracy with acceptable discomfort of FNAB make it useful in diagnosis of pancreatic carcinoma. Ultrasound guided fine-needle biopsy is a safe and feasible method for diagnosing pancreatic cancer. Pancreatic carcinoma has the highest K-ras mutation rate among all solid tumors. The mutation rate of k-ras is about 80-100 %. The usage of mutation of codon 12 of k-ras oncogene combined with cytology is a good alternative for evaluation of pancreatic masses.
目的
探讨超声引导下胰腺肿块细针穿刺活检的K-ras基因突变分析的效用。
方法
对66例超声引导下细针活检进行细胞学、组织学和K-ras基因突变评估。采用Bst NI方法通过人工限制性片段长度多态性检测K-ras癌基因第12密码子的突变。
结果
54例胰腺癌中有40例报告存在恶性细胞，54例胰腺癌的细针穿刺抽吸活检（FNAB）中有45例检测到K-ras基因突变。细胞学和K-ras基因突变的敏感性分别为74%和83%。细胞学和K-ras基因突变的特异性均为100%。K-ras基因突变联合细胞学的敏感性和特异性分别为83%和100%。
结论
细针穿刺抽吸活检（FNAB）诊断准确性高且不适可接受，使其在胰腺癌诊断中有用。超声引导下细针活检是诊断胰腺癌的一种安全可行的方法。胰腺癌在所有实体瘤中K-ras基因突变率最高。K-ras基因第12密码子突变率约为80%-100%。K-ras癌基因第12密码子突变联合细胞学的应用是评估胰腺肿块的一个良好选择。
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