p16和K-ras突变在胰腺腺癌与慢性胰腺炎鉴别诊断中的应用价值。
Usefulness of p16 and K-ras mutation in pancreatic adenocarcinoma and chronic pancreatitis differential diagnosis.
作者信息
Talar-Wojnarowska R, Gasiorowska A, Smolarz B, Romanowicz-Makowska H, Strzelczyk J, Janiak A, Kulig A, Malecka-Panas E
机构信息
Department of Digestive Tract Diseases, Medical University, Lodz, Poland.
出版信息
J Physiol Pharmacol. 2004 Jul;55 Suppl 2:129-38.
BACKGROUND
The differentiation of chronic pancreatitis (CP) from pancreatic adenocarcinoma (PA) remains a great challenge. The purpose of the study was to compare the prevalence of p16 and K-ras mutation in PA and CP in order to evaluate their usefulness in differential diagnosis of those diseases.
METHODS
The study included 44 patients who underwent Whipple resection or distal pancreatectomy for PA (23 subjects) or CP (21 subjects). DNA from pancreatic tissue was analysed for K-ras mutation (codon 12) and p16 mutations with PCR amplifications.
RESULTS
The K-ras gene mutation has been shown in 17 (73,9%) cases with pancreatic adenocarcinoma which was significantly more often than in chronic pancreatitis - 9 (42,8%) (p<0,01). Prevalence of p16 mutations in patients with PA was 18 (78,3%) and with CP - 7 (33,3%) (p<0,01). K-ras and p16 mutations together have been observed in 16 (69,6%) cases in patients with PC and only in 3 (14,3%) - with CP (p<0,01). No statistically significant association between K-ras or p16 mutations and tumor size, sex or patient age has been observed.
CONCLUSION
It is suggested that simultaneous measurement of K-ras and p16 mutations may provide an additional tool in differential diagnosis of chronic pancreatitis and pancreatic adenocarcinoma.
背景
慢性胰腺炎(CP)与胰腺腺癌(PA)的鉴别诊断仍然是一个巨大挑战。本研究旨在比较PA和CP中p16和K-ras突变的发生率,以评估它们在这些疾病鉴别诊断中的作用。
方法
本研究纳入44例因PA(23例)或CP(21例)接受Whipple手术或胰腺远端切除术的患者。采用PCR扩增技术分析胰腺组织DNA中的K-ras突变(密码子12)和p16突变。
结果
17例(73.9%)胰腺腺癌患者出现K-ras基因突变,显著高于慢性胰腺炎患者的9例(42.8%)(p<0.01)。PA患者中p16突变的发生率为18例(78.3%),CP患者为7例(33.3%)(p<0.01)。PC患者中有16例(69.6%)同时出现K-ras和p16突变,而CP患者中仅3例(14.3%)出现(p<0.01)。未观察到K-ras或p16突变与肿瘤大小、性别或患者年龄之间存在统计学显著关联。
结论
建议同时检测K-ras和p16突变可能为慢性胰腺炎和胰腺腺癌的鉴别诊断提供额外的工具。