Ogreid D, Ulvik A, Horn A, Søndenaa K
Senter for klinisk molekylaermedisin, Haukeland Sykehus, Bergen.
Tidsskr Nor Laegeforen. 1994 Oct 30;114(26):3079-81.
The prognosis for pancreatic carcinoma is generally poor. The chance of survival could be improved if curative surgery were performed, but early diagnosis is then essential. Fine-needle aspiration cytology and endoscopic retrograde cholepancreaticography (ERCP) are widely used in order to obtain a precise diagnosis before laparotomy. In almost all patients with pancreatic adenocarcinomas, the oncogene Ki-ras is activated by point mutation. We describe a patient where conventional diagnostic procedures were inconclusive. However, DNA-analysis of aspirate from the pancreatic duct and from a pancreatic cyst showed activated Ki-ras oncogene. A malignant diagnosis was later confirmed. We propose that DNA-analyses of pancreatic fluid or tissues should be used whenever facing problems with an early and accurate diagnosis of pancreatic lesions.
胰腺癌的预后通常很差。如果能进行根治性手术，生存几率可能会提高，但早期诊断至关重要。细针穿刺细胞学检查和内镜逆行胆胰管造影术（ERCP）被广泛应用，以便在剖腹手术前获得精确诊断。在几乎所有胰腺腺癌患者中，癌基因Ki-ras通过点突变被激活。我们描述了一位患者，其传统诊断程序无法得出结论。然而，对胰管抽吸物和胰腺囊肿进行的DNA分析显示存在激活的Ki-ras癌基因。后来确诊为恶性。我们建议，在面临胰腺病变早期准确诊断问题时，应采用胰腺液或组织的DNA分析。
