Suenaga Masaya, Dudley Beth, Karloski Eve, Borges Michael, Irene Canto Marcia, Brand Randall E, Goggins Michael
Pancreas. 2018 Jan;47(1):35-39. doi: 10.1097/MPA.0000000000000956.
Secretin-stimulated pancreatic juice is collected from the duodenum and analyzed to identify biomarkers of pancreatic neoplasia, but the optimal duration of pancreatic juice collection is not known.
We compared the yield of KRAS mutations detected in pancreatic juice samples aspirated from near the duodenal papilla at 1 to 5, 6 to 10, and 11 to 15 minutes after secretin infusion, and from the third part of the duodenum (at 15 minutes) from 45 patients undergoing endoscopic ultrasound pancreatic surveillance. KRAS mutation concentrations were measured by using droplet digital polymerase chain reaction.
Forty of 45 patients had KRAS mutations detected in their pancreatic juice, and most patients' juice samples had more than 1 KRAS mutation. Of 106 KRAS mutations detected in 171 pancreatic juice samples, 58 were detected in the 5-minute samples, 70 mutations were detected in the 10-minute samples, and 65 were detected in the 15-minute samples. Nine patients who did not have KRAS mutations detected in their 5-minute sample had mutations detected in samples collected at later time points. Ninety-percent of all pancreatic juice mutations detected in any sample were detected in the 5- or 10-minute samples.
Collecting pancreatic juice for 10 minutes after secretin infusion increases the likelihood of detecting pancreatic juice mutations over shorter collections.
从十二指肠收集促胰液素刺激后的胰液并进行分析，以鉴定胰腺肿瘤的生物标志物，但胰液收集的最佳时长尚不清楚。
我们比较了45例接受内镜超声胰腺监测的患者在注入促胰液素后1至5分钟、6至10分钟、11至15分钟时从十二指肠乳头附近吸出的胰液样本以及在15分钟时从十二指肠第三部分吸出的胰液样本中检测到的KRAS突变率。使用液滴数字聚合酶链反应测量KRAS突变浓度。
45例患者中有40例在其胰液中检测到KRAS突变，且大多数患者的胰液样本有不止1个KRAS突变。在171份胰液样本中检测到的106个KRAS突变中，5分钟样本中检测到58个，10分钟样本中检测到70个，15分钟样本中检测到65个。9例在5分钟样本中未检测到KRAS突变的患者在之后采集的样本中检测到了突变。在任何样本中检测到的所有胰液突变中有90%在5分钟或10分钟样本中被检测到。
促胰液素注入后收集10分钟胰液比更短时间的收集更有可能检测到胰液突变。
