High proportion of mutant K-ras gene in pancreatic juice of patients with pancreatic cystic lesions
High proportion of mutant K-ras gene in pancreatic juice of patients with pancreatic cystic lesions
复制标题
胰腺囊性病变患者胰液中K-ras突变基因比例较高
作者：
K. Tateishi;M. Tada;M. Yamagata;H. Isayama;Y. Komatsu;T. Kawabe;Y. Shiratori;M. Omata
背景/目的近年来有报道称，对胰液中突变型K-ras基因进行定量分析，可用于胰腺癌的诊断。该方法适用于胰腺囊性病变患者。方法采用胰泌素注射法，从内镜检查时收集的胰液中提取DNA。采用聚合酶链反应/优先同源双链形成试验和富集聚合酶链反应/酶联微序列分析两种方法检测和半定量突变型K-ras基因，测定突变型K-ras等位基因与野生型等位基因的比值。结果14例胰腺囊肿患者中有6例（43%）检测到K-ras基因的高频率突变（超过所有K-ras基因的2%）。该频率与胰腺癌和胰腺导管内乳头状肿瘤患者中检测到的频率相似。相比之下，在没有胰腺囊肿或胰腺肿瘤的患者中，突变频率较低（小于2%）。结论K-ras基因突变可能来源于胰腺导管细胞，具有较高的致瘤潜力。因此，如果发现胰腺囊肿患者的胰液中有高水平的突变基因，建议对他们进行仔细的随访。
BACKGROUND/AIMS It was recently reported that the quantitative analysis of mutant K-ras gene in pancreatic juice could be useful for the diagnosis of pancreatic cancer. This methodology was applied to patients with pancreatic cystic lesions. METHODS DNA was extracted from pancreatic juice collected at the time of endoscopy with injection of secretin. The ratio of the K-ras mutant allele to the wild-type allele was measured by two methods to detect and semiquantify mutant K-ras gene: polymerase chain reaction/preferential homoduplex formation assay and enriched polymerase chain reaction/enzyme linked mini-sequence assay. RESULTS A high frequency of K-ras mutation was detected (more than 2% of all K-ras genes) in six of 14 patients (43%) with pancreatic cysts. This frequency was similar to those detected in patients with pancreatic adenocarcinoma and in intraductal papillary neoplasms of the pancreas. In contrast, the frequency of mutation was low (less than 2%) in patients without either pancreatic cysts or pancreatic neoplasms. CONCLUSIONS K-rasgene mutation may be derived from duct cells in the pancreas with a high potential for tumorigenesis. Therefore careful follow up of patients with a pancreatic cyst is recommended if they are found to have a high level of the mutant gene in the pancreatic juice.