Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Pancreas. 2010 Jul;39(5):617-21. doi: 10.1097/MPA.0b013e3181c75d9b.
One or more patterns of 6 K-ras mutations are detected in cells from the pancreatic juice of patients with intraductal papillary mucinous neoplasms (IPMNs). We investigated whether these mutations are associated with malignant progression.
Between January 2002 and December 2007, 53 patients with IPMN were subjected to collection of pure pancreatic juice to evaluate K-ras mutation. According to the histological and radiological findings, the IPMNs were classified into 4 groups: carcinoma group, adenoma group, high-risk group, and low-risk group. We retrospectively investigated the mutation with these groups.
In patients with a positive K-ras mutation, a single pattern of K-ras mutation was observed in 80% (8/10) of the carcinoma group, in 71% (5/7) of the adenoma group, in 40% (2/5) of the high-risk group, and in 38% (8/21) of the low-risk group. The rate of a single pattern of K-ras mutation decreased in a stepwise order (P = 0.017). The incidence of a single pattern of K-ras mutation was significantly higher in the patients who received surgical therapy (75%, 12/16) than in those who did not (38%, 10/26; P = 0.033).
The present study suggests that the single-clonal convergence of K-ras mutation is associated with the malignant progression of IPMNs.
在胰管内乳头状黏液性肿瘤（IPMNs）患者的胰液细胞中检测到一种或多种 6 K-ras 突变模式。我们研究了这些突变是否与恶性进展有关。
2002 年 1 月至 2007 年 12 月，53 例 IPMN 患者采集纯胰液以评估 K-ras 突变。根据组织学和影像学发现，将 IPMNs 分为 4 组：癌组、腺瘤组、高危组和低危组。我们回顾性地调查了这些组的突变情况。
在 K-ras 突变阳性的患者中，癌组中 80%（8/10）、腺瘤组中 71%（5/7）、高危组中 40%（2/5）和低危组中 38%（8/21）观察到单一 K-ras 突变模式。K-ras 突变的单一模式的发生率呈阶梯式下降（P=0.017）。接受手术治疗的患者（75%，12/16）单一 K-ras 突变模式的发生率明显高于未接受手术治疗的患者（38%，10/26；P=0.033）。
本研究表明，K-ras 突变的单克隆汇聚与 IPMNs 的恶性进展有关。
