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A new combination of endoscopic ultrasonography and DNA diagnosis using pancreatic juice for the early detection of pancreatic cancer

内窥镜超声检查和胰液 DNA 诊断的新组合用于早期发现胰腺癌

基本信息

批准号：
06670530
负责人：
OKAI Takashi
金额：
$ 1.22万
依托单位：
Kanazawa University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1994
资助国家：
日本
起止时间：
1994 至 1995
项目状态：
已结题

项目摘要

The combination of endoscopic ultrasonography and DNA diagnosis using pancreatic juice for the detection of small pancreatic cancer was evaluated. The patients with upper abdominal pain. abnormal laboratory data or images on the pancreas, or worsening of diabetic control were enrolled in this study. When the findings of a small pancreatic mass or dilated pancreatic duct were detected by endoscopic ultrasonography, the pure pancreatic juice was collected under a duodenofiberscope for the analyzes of k-ras point mutation at codon 12. The pancreatic cancers less than 2 cm in a diameter were clearly visualized as round hypoechoic tumors with irregular margin. The pancreatic ducts were abruptly dilated caudal to the tumors. Although inflammatory pancreatic masses were generally visualized as square-shaped hypoechoic area without compression or encasement of the neighboring pancreatic ducts, the differentiation from small pancreatic cancer was not always complete, particularly when the tumor was round and the size was less than 1 cm. The incidence of k-ras point mutation analyzed by PCR-RFLP method was 78% (29/37) in patients with pancreatic cancer and 9% (5/53) in those with chronic pancreatitis. The correlation between the incidence of k-ras mutation and tumor size/location were not seen. These results suggest that the combination of endoscopic ultrasonography and DNA diagnosis using pancreatic juice is useful and promising to the early detection of pancreatic cancer.

评价超声内镜与胰液DNA联合诊断对小胰腺癌的诊断价值。患者有上腹部疼痛。本研究纳入了胰腺异常的实验室数据或图像，或糖尿病控制恶化。当超声内镜检查发现胰腺小肿块或胰管扩张时，在十二指肠纤维镜下采集纯胰液，分析k-ras密码子12点突变。直径小于2cm的胰腺肿瘤清晰可见为圆形低回声肿瘤，边缘不规则。胰管突然向肿瘤尾部扩张。虽然炎性胰腺肿块通常表现为方形低回声区，未压迫或包裹邻近胰管，但与小胰腺癌的鉴别并不总是完全的，特别是当肿瘤为圆形且小于1cm时。PCR-RFLP法分析k-ras点突变在胰腺癌患者中发生率为78%(29/37)，在慢性胰腺炎患者中发生率为9%（5/53）。k-ras突变发生率与肿瘤大小/位置的相关性未见。提示超声内镜与胰液DNA联合诊断对早期发现胰腺癌有一定的应用价值。