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通过检测粪便和胰液中的K-ras和p53基因突变来诊断早期胰腺癌。

Detecting K-ras and p53 gene mutation from stool and pancreatic juice for diagnosis of early pancreatic cancer.

作者信息

Lu Xinghua, Xu Tong, Qian Jiaming, Wen Xiaoheng, Wu Dongsheng

机构信息

Peking Union Medical Hospital, Beijing 100730, China.

出版信息

Chin Med J (Engl). 2002 Nov;115(11):1632-6.

Abstract

OBJECTIVE

To explore new methods for the early diagnosis of pancreatic cancer through detection of K-ras and p53 mutations in pancreatic juice and stool.

METHODS

201 patients in PUMC Hospital from 1994 - 2000 and 60 control individuals were enrolled in this study. K-ras point mutation was detected by PCR-RFLP while p53 mutation was detected by PCR-SSCP.

RESULTS

K-ras mutation was found in pancreatic juice in 87.8% (36/41) of pancreatic cancer patients and 23.5% (4/17) of benign pancreatic disease patients. In 261 stool specimens, amplification found mutations successfully in 235 patients (90%). K-ras mutation was found in stool in 88% (66/75) of pancreatic cancer patients, 51.1% (24/47) of benign pancreatic disease patients and 19.6% (9/46) of normal individuals. p53 mutation was found in pancreatic juice in 47.4% (18/38) of pancreatic cancer patients and 12.5% (2/16) of benign pancreatic disease patients. p53 mutation was found in stool in 37.1% (23/62) and 19.1% (4/21) of chronic pancreatitis patients.

CONCLUSION

K-ras mutation in pancreatic juice has higher diagnosis sensitivity and specificity, and therefore may be used as a supplement in the diagnosis of pancreatic cancer. Detection of K-ras mutation combined with p53 mutation in stool can aid in the screening of pancreatic cancer.

摘要

目的

通过检测胰液和粪便中的K-ras和p53突变,探索胰腺癌早期诊断的新方法。

方法

选取1994年至2000年在协和医院就诊的201例患者及60例对照个体纳入本研究。采用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)检测K-ras点突变,采用聚合酶链反应-单链构象多态性(PCR-SSCP)检测p53突变。

结果

胰腺癌患者胰液中K-ras突变率为87.8%(36/41),良性胰腺疾病患者为23.5%(4/17)。在261份粪便标本中,235例患者(90%)成功扩增出突变。胰腺癌患者粪便中K-ras突变率为88%(66/75),良性胰腺疾病患者为51.1%(24/47),正常个体为19.6%(9/46)。胰腺癌患者胰液中p53突变率为47.4%(18/38),良性胰腺疾病患者为12.5%(2/16)。慢性胰腺炎患者粪便中p53突变率分别为37.1%(23/62)和19.1%(4/21)。

结论

胰液中K-ras突变具有较高的诊断敏感性和特异性,可作为胰腺癌诊断的补充手段。粪便中K-ras突变与p53突变联合检测有助于胰腺癌的筛查。

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