Villanueva A, Reyes G, Cuatrecasas M, Martínez A, Erill N, Lerma E, Farré A, Lluís F, Capellá G
Laboratori d'Investigació Gastrointestinal, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Gastroenterology. 1996 May;110(5):1587-94. doi: 10.1053/gast.1996.v110.pm8613066.
BACKGROUND & AIMS: Mutations at codon 12 of the K-ras gene are present in 65%-100% of carcinomas of human exocrine pancreas and could be used as a potential tumor marker at the tissue level. The purpose of this study was to assess, in large series of patients, the utility of K-ras mutation analysis to evaluate fine-needle aspirates of pancreatic masses.
One hundred fifteen fine-needle aspirates obtained from 93 patients were evaluated retrospectively. Cytological analysis was based on the review of cell blocks. Mutations were detected by using artificial restriction fragment length polymorphisms using the Hphl and BstNl approaches.
The sensitivity and specificity of cell block cytology was 64% and 100%, respectively, for the diagnosis of pancreatic carcinoma. K-ras mutations were detected in 41 pancreatic carcinomas (sensitivity, 59%) and in one mucinous cystic tumor; specificity of ras analysis alone was 100%. The sensitivity of cytology combined with K-ras mutations were 77.6% and 100%, respectively.
The detection of K-ras mutations would have suggested the diagnosis of pancreatic cancer in 14 cases otherwise not detected by cytology alone. K-ras mutation analysis should be restricted to cell blocks containing suspicious, normal-appearing duct cells, or insufficient material in the cytological examination.
K-ras基因第12密码子的突变存在于65%-100%的人外分泌性胰腺癌中，可作为组织水平上潜在的肿瘤标志物。本研究的目的是在大量患者中评估K-ras突变分析对评估胰腺肿块细针穿刺抽吸物的效用。
回顾性评估了从93例患者获得的115份细针穿刺抽吸物。细胞学分析基于对细胞块的检查。使用Hphl和BstNl方法通过人工限制性片段长度多态性检测突变。
细胞块细胞学诊断胰腺癌的敏感性和特异性分别为64%和100%。在41例胰腺癌（敏感性59%）和1例黏液性囊性肿瘤中检测到K-ras突变；单独的ras分析特异性为100%。细胞学联合K-ras突变的敏感性分别为77.6%和100%。
K-ras突变的检测可在14例单独细胞学检查未发现的病例中提示胰腺癌的诊断。K-ras突变分析应限于含有可疑的、外观正常的导管细胞或细胞学检查中材料不足的细胞块。
