Bastian D, Gerdes B, Ramaswamy A, Tschammer C, Bartsch D
Klinik für Allgemeinchirurgie, Philipps-Universität Marburg.
Langenbecks Arch Chir Suppl Kongressbd. 1998;115(Suppl I):45-7.
In this prospective study we evaluated the presence and importance of hepatic micrometastases at the time of operation in patients with resectable pancreatic carcinoma. In 13 patients with pancreatic carcinoma and 5 patients with chronic pancreatitis Truecut-Needle biopsies of the liver were obtained during operation. K-ras mutation analysis was done by the PCR/restriction digestion assay with HphI, followed by an ultrasound of the liver in 3 monthly intervals. Four of 13 (30%) pancreatic cancer patients had K-ras gene mutations in the liver and had a mean survival of 6 months after resection. All chronic pancreatitis patients and 8 of the 9 remaining pancreatic cancer patients without K-ras mutations in the liver biopsies are alive without evidence of liver metastases after a mean follow-up of 9 months. Detection of micrometastases in the liver by K-ras mutation analysis might be a powerful tool to identify occult clinical relevant liver metastases.
在这项前瞻性研究中，我们评估了可切除胰腺癌患者手术时肝微转移的存在情况及其重要性。在13例胰腺癌患者和5例慢性胰腺炎患者手术期间，采用Truecut针进行肝脏活检。采用HphI进行PCR/限制性消化分析检测K-ras基因突变，随后每3个月进行一次肝脏超声检查。13例胰腺癌患者中有4例（30%）肝脏存在K-ras基因突变，切除术后平均生存6个月。所有慢性胰腺炎患者以及肝脏活检未发现K-ras基因突变的其余9例胰腺癌患者中的8例，在平均随访9个月后仍存活，无肝转移迹象。通过K-ras基因突变分析检测肝脏微转移可能是识别隐匿性临床相关肝转移的有力工具。
