胰腺超声内镜细针穿刺活检物中K—ras基因定量检测对胰腺癌诊断价值的研究  

Quantitative detection of K-ras gene mutation in samples from endoscopic ultrasound-guided fineneedle aspiration for pancreatic cancer

作　　者：王小玮[1] 高军[1] 顾俊骏[1] 路华[1] 金震东[1] 李兆申[1] 龚燕芳[1] 金晶[1] 

机构地区：[1]第二军医大附属长海医院消化内科,上海200433

出　　处：《中华消化内镜杂志》2011年第3期126-130,共5页Chinese Journal of Digestive Endoscopy

基　　金：国家科技支撑计划课题资助

摘　　要：目的比较不同胰腺超声内镜细针穿刺物中K—ras突变定量值，评价其对胰腺癌辅助诊断的价值。方法收集53例胰腺占位病变的超声内镜细针穿刺物，采用肽核酸（PNA）钳制实时定量PER的方法检测K—ras基因野生及突变拷贝数，根据临床综合诊断，与细胞学比较，评价其诊断价值。结果53例患者最后确诊为胰腺癌37例，非恶性胰腺占位16例，胰腺癌组K—ras基因的突变率为83．8％，非恶性胰腺占位组突变率为18．8％，两组之间比较差异有统计学意义（P〈0．05）。细胞学和K—ran定量检测诊断的灵敏度分别为59．5％和83．8％，将两者联合后诊断胰腺癌的灵敏度可提高至89．2％。结论胰腺组织超声内镜细针穿刺物中K—ras定量检查对胰腺癌有临床辅助诊断价值。Objective To investigate the diagnostic value of a quantitative detection of K-ras muta- tion in samples from endoscopic ultrasound-guided fine-needle aspiration （EUS-FNA） of pancreatic cancer. Methods Samples taken by EUS-FNA from 53 pancreatic occupying lesions were collected, and the copies of wild-type and mutated K-ras gene was measured by PNA-elamping real-time quantitative PCR. The resuhs were analyzed with refer to cytological findings to evaluate its clinical values. Results According to cytological finding, a total of 37 cases were diagnosed as pancreatic cancer, and 16 were non-malignant lesions. Kras mutation was detected in 83.8% of cancer cases, and 18.8% of non-cancer cases, which was significantly different （P 〈0. 05）. Sensitivities of cytology and K-ras examination were 59.5% and 83.8% , re- spectively, while that of combination of cytology and K-ras examination was 89. 2%. Conclusion Quantitative analysis of the mutant K-ras gene in samples taken by EUS-FNA is a useful tool for diagnosing the pancreatic carcinoma.

关 键 词：胰腺癌 内窥镜超声检查 穿刺活检 基因 RAS 

分 类 号：R735.9[医药卫生—肿瘤]