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外周血K-ras基因突变和CA19-9的联合检测在胰腺癌诊断中的作用

Combined detection of K-ras mutation and CA19-9 level in plasma of patients with pancreatic cancer

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【作者】 戴梦华; 赵玉沛; 蔡力行; 朱预;

【Author】 DAI Meng-hua, ZHAO Yu-pei, CAI Li-xing, ZHU Yu. Department of General Surgery. Peking Union Medical College Hospital, Chinese Academy of Medical Sciences,Beijing 100730, China

【机构】 中国医学科学院中国协和医科大学北京协和医院普外科; 中国医学科学院中国协和医科大学北京协和医院普外科 100730; 100730;

【摘要】 目的 研究K ras基因突变和CA19 9联合检测在胰腺癌诊断中的作用。 方法 选择同期的 15例胰腺癌和 33非胰腺癌病人 ,同时行外周血K ras基因突变和CA19 9的检测 ,利用统计学方法进行数据分析。 结果 外周血K ras基因突变和CA19 9联合检测诊断胰腺癌的敏感性、特异性分别为 6 6 6 7%和 97% ,研究组和对照组之间差异具有显著性意义 (P =0 0 0 1)。 结论 外周血K ras基因突变和CA19 9的联合检测显著提高了胰腺癌诊断的特异性 ,弥补了单一K ras基因突变和CA19 9检测的不足 ,可用于胰腺癌的辅助诊断。

【Abstract】 Objective To confirm the effect of combined detection of K-ras gene mutation and CA19-9 level in plasma in the diagnosis of pancreatic cancinoma. Methods In 33 patients without pancreatic carcinoma and 15 patients with pancreatic carcinoma, the value of K-ras mutation and CA19-9 level were examined by enriched polymerase chain reaction (PCR) restriction fragment length polymorphism(RFLP) and radioimmunoassay respectively. The data were analysed with χ 2 test, Fisher′s exact test and Kruekal-wall′s test. All patients were confimed pathologically. Results Eleven of the 15 patients with pancreatic carcinoma and 2 of 10 patients with chronic pancreatitis were found K-ras mutation. CA19-9 level in patients with pancreatic cancer was significantly higher than that in those with benign disease but with a low specificity. The sensitivity, specificity of combined detection of K-ras gene mutation and CA19-9 level in the plasma of patients with pancreatic cancer were 66.67% and 97%. There was a significant difference between patients with pancreatic cancer and those without pancreatic cancer. Pathological examination showed atypical hyperplasia in one patient with chronic pancreatitis who had K-ras mutation and higher CA19-9 level. Conclusions Combined detection of K-ras gene mutation and CA19-9 can be used for adjuvant diagnosis of pancreatic cancer. It is more specific than detection of single K-ras gene mutation or CA19-9 level in the plasma. The method is complementary to single detection of K-ras gene mutation or CA19-9 level because it decreases the rate of false-positive diagnosis.

  • 【文献出处】 中华外科杂志 ,Chinese Journal of Surgery , 编辑部邮箱 ,2003年05期
  • 【分类号】R735.9
  • 【被引频次】12
  • 【下载频次】133
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