Talar-Wojnarowska Renata, Gasiorowska Anita, Smolarz Beata, Romanowicz-Makowskal Hanna, Strzelczyk Janusz, Janiak Adam, Malecka-Panas Ewa
Department of Digestive Tract Diseases, Medical University, Lodz, Poland.
Hepatogastroenterology. 2006 Jul-Aug;53(70):608-12.
BACKGROUND/AIMS: Pancreatic adenocarcinoma (PA) has a very poor prognosis. In patients suffering from chronic pancreatitis (CP) the risk for the PA development is higher than in the general population. The purpose of the study was to compare the prevalence of p53 mutations in PA and CP in order to evaluate their usefulness in differential diagnosis of those diseases.
We examined 49 patients who underwent Whipple resection or distal pancreatectomy for pancreatic adenocarcinoma (26 subjects) or chronic pancreatitis (23 subjects). DNA from pancreatic tissue was analyzed for p53 mutations with PCR/SSCP methods.
The p53 gene mutation has been shown in 16 (61.5%) of the PA patients (9 in exon 5 and 7 in exon 7) and in 2 (8.6%) of CP patients (1 in exon 5 and 1 in exon 8; p < 0.001). There was a significant correlation between p53 mutation and G3 tumor differentiation (p < 0.01). Overall median survival in patients with PA was 8.5 months. No relationship between presence of p53 mutation and survival time in PA patients has been observed.
The specificity of p53 mutation for pancreatic cancer is very high. Our results indicate that p53 gene mutation may provide an additional tool in differential diagnosis of CP and PC.
背景/目的：胰腺腺癌（PA）的预后很差。在患有慢性胰腺炎（CP）的患者中，发生PA的风险高于普通人群。本研究的目的是比较PA和CP中p53突变的发生率，以评估其在这些疾病鉴别诊断中的作用。
我们检查了49例接受了Whipple手术或胰腺远端切除术的患者，其中26例为胰腺腺癌患者，23例为慢性胰腺炎患者。采用PCR/SSCP方法分析胰腺组织DNA中的p53突变。
PA患者中有16例（61.5%）出现p53基因突变（外显子5中有9例，外显子7中有7例），CP患者中有2例（8.6%）出现p53基因突变（外显子5中有1例，外显子8中有1例；p<0.001）。p53突变与G3肿瘤分化之间存在显著相关性（p<0.01）。PA患者的总体中位生存期为8.5个月。未观察到PA患者中p53突变的存在与生存时间之间的关系。
p53突变对胰腺癌的特异性非常高。我们的结果表明，p53基因突变可能为CP和PC的鉴别诊断提供一个额外的工具。
