Korean J Gastroenterol.
2000 Jan;35(1):93-102.
Diagnostic Utility of K-ras Mutation in the Sample of Percutaneous
Needle Aspiraton of Pancreatic Cancer and Chronic Pancreatitis
Abstract
- BACKGROUND/AIMS
K-ras gene mutation is present in 80-90% of human
pancreatic cancer and thus, could be used as a new diagnostic tool.
The purpose of this study was to assess the utility of K-ras mutation
analysis in the differential diagnosis of pancreatic diseases using
the percutaneous needle aspirates of pancreatic masses. METHODS: Aspirates
of 16 patients with pancreatic cancer, 4 patients with chronic pancreatitis
and 4 patients with pancreatic cysts were collected prospectively.
Cytological analysis was performed and DNA was extracted simultaneously
from the samples. K-ras mutations were detected by the enriched polymerase
chain reaction-restriction fragment length polymorphism method and the DNA
sequence was analyzed. RESULTS: K-ras mutations were detected in 9 (56%)
of 16 cases of pancreatic cancer. Cytological analysis for the patients
with pancreatic cancer revealed malignant tumors in nine patients,
atypia in two, and benign tumors in five. In combination with cytological analysis,
detection of K-ras mutations offered a diagnostic sensitivty of 81%.
The most frequently observed mutation was G-A transitions (GGT-GAT) at codon 12,
resulting in alteration of Glycine to Aspartic acid. However, 1 of 4 patients
with chronic pancreatitis and 2 of 4 patients with pancreatic cysts also
showed K-ras mutation. CONCLUSIONS: Although the detection of K-ras mutation
from the percutaneous needle aspirates can enhance the sensitivity for
the diagnosis of pancreatic cancer, its clinical use is limited because
of the nonspecificity.