Motojima K, Tsunoda T, Kanematsu T, Nagata Y, Urano T, Shiku H
Second Department of Surgery, Nagasaki University School of Medicine, Japan.
Ann Surg. 1991 Dec;214(6):657-62. doi: 10.1097/00000658-199112000-00003.
The prevalence of Kirsten (Ki)-ras gene mutations was studied in 105 paraffin-embedded tissues obtained from 40 patients with pancreatic cancer, 48 with bile duct carcinoma (19 distal, 6 middle, and 23 proximal), 16 with ampullary carcinoma and 1 with duodenal cancer, by in vitro amplification of target sequences by the polymerase chain reaction (PCR). With regard to pancreatic cancers, the authors' data confirm the very high frequency (88.6%) of Ki-ras gene mutations occurring at codon 12. Five pancreatic carcinomas did not contain the Ki-ras mutation and included rare types of histopathology. By histologic review after the examination of Ki-ras mutations through PCR, the diagnosis of four patients could be legitimately revised from other periampullary carcinoma to pancreatic carcinoma. In the ampullary carcinoma, the prevalence of mutations in Ki-ras codon 12 was 13.3%. Although there was a large difference in incidence of mutations between distal and middle or proximal bile duct carcinoma, the prevalence of mutations in bile duct carcinoma was limited to 19.6%. Unlike other approaches to diagnose periampullary carcinoma, detection of a mutation in Ki-ras codon 12 by PCR may distinguish pancreatic carcinoma from other periampullary carcinomas that have better prognoses.
通过聚合酶链反应（PCR）体外扩增靶序列，对取自40例胰腺癌、48例胆管癌（19例远端、6例中段和23例近端）、16例壶腹癌和1例十二指肠癌患者的105份石蜡包埋组织进行了 Kirsten（Ki）-ras 基因突变率的研究。关于胰腺癌，作者的数据证实了密码子12处发生 Ki-ras 基因突变的频率非常高（88.6%）。5例胰腺癌未发生 Ki-ras 突变，包括罕见的组织病理学类型。通过PCR检测 Ki-ras 突变后进行组织学复查，4例患者的诊断可从其他壶腹周围癌合理地修正为胰腺癌。在壶腹癌中，Ki-ras 密码子12的突变率为13.3%。尽管远端胆管癌与中段或近端胆管癌的突变发生率存在很大差异，但胆管癌的突变率仅限于19.6%。与诊断壶腹周围癌的其他方法不同，通过PCR检测 Ki-ras 密码子12的突变可将胰腺癌与其他预后较好的壶腹周围癌区分开来。
