Lu Xinghua, Xu Tong, Qian Jiaming, Wen Xiaoheng, Wu Dongsheng
Peking Union Medical Hospital, Beijing 100730, China.
Chin Med J (Engl). 2002 Nov;115(11):1632-6.
To explore new methods for the early diagnosis of pancreatic cancer through detection of K-ras and p53 mutations in pancreatic juice and stool.
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.
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.
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.
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。
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。
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）。
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。
