Inoue S, Nakao A, Kasai Y, Harada A, Nonami T, Takagi H
Department of Surgery II, Nagoya University School of Medicine.
Jpn J Cancer Res. 1995 Jul;86(7):626-30. doi: 10.1111/j.1349-7006.1995.tb02444.x.
Hepatic metastasis and retroperitoneal recurrence generally are considered to be the two primary modes of recurrence in pancreatic cancer. The goal of this study was to determine if patients with pancreatic adenocarcinoma have hepatic and peritoneal micrometastasis at operation. Pancreatic adenocarcinomas are known to have a high incidence of K-ras gene mutations. Liver tissue specimens were obtained from 30 patients (17 with pancreatic adenocarcinoma and 13 with other diseases) with a biopsy needle at operation. Peritoneal washings were obtained during operation from 20 patients with pancreatic adenocarcinoma. Two-stage polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) analysis were used to detect K-ras oncogene mutation at codon 12. Thirteen of 17 pancreatic adenocarcinoma patients had K-ras gene mutations in the liver, whereas all 13 patients with other diseases did not. However, only two of 20 pancreatic adenocarcinoma patients revealed K-ras gene mutation in peritoneal lavage fluids. These results indicate the feasibility of detecting hepatic micrometastasis in patients with pancreatic adenocarcinoma, and imply that PCR/RFLP analysis may be of value in the diagnosis, treatment and follow-up of hepatic metastasis of pancreatic adenocarcinoma.
肝转移和腹膜后复发通常被认为是胰腺癌复发的两种主要方式。本研究的目的是确定胰腺腺癌患者在手术时是否存在肝和腹膜微转移。已知胰腺腺癌中K-ras基因突变的发生率很高。在手术时用活检针从30例患者（17例胰腺腺癌患者和13例患有其他疾病的患者）获取肝组织标本。在手术中从20例胰腺腺癌患者获取腹腔灌洗液。采用两阶段聚合酶链反应（PCR）和限制性片段长度多态性（RFLP）分析检测第12密码子处的K-ras癌基因突变。17例胰腺腺癌患者中有13例在肝脏中存在K-ras基因突变，而13例患有其他疾病的患者均未出现。然而，20例胰腺腺癌患者中只有2例在腹腔灌洗液中检测到K-ras基因突变。这些结果表明检测胰腺腺癌患者肝微转移的可行性，并提示PCR/RFLP分析在胰腺腺癌肝转移的诊断、治疗及随访中可能具有价值。
