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目的 :了解胰腺癌患者血浆中肿瘤标志物水平和k ras基因突变情况 ,评价基因突变与肿瘤标志物联合检测对胰腺癌患者的诊断价值。方法 :收集经手术或病理确诊为胰腺恶性疾病患者 2 1例 ,ELISA检测血浆CA19 9、CA2 42、CA5 0、CEA水平 ,PCR RFLP检测k ras基因突变 ,并与 11例胰腺良性疾病患者对照。结果 :胰腺癌患者血浆中k ras基因突变率 73.7%,胰腺良性疾病k ras基因无突变。k ras基因突变检测的敏感性与特异性分别为 6 1.9%和10 0 %,血浆k ras、CA19 9、CA2 42联合检测的敏感性和特异性分别为 85 .7%和 71.9%。结论 :联合检测血浆中k ras基因与肿瘤标志物可提高胰腺癌诊断的敏感性 ,对胰腺癌筛查、诊断与鉴别诊断有一定的临床意义。
OBJECTIVE: To investigate the plasma levels of tumor markers and k ras gene mutations in patients with pancreatic cancer and to evaluate the diagnostic value of combined detection of genetic mutations and tumor markers in patients with pancreatic cancer. Methods: Twenty-one patients with malignant pancreatic disease were collected surgically or pathologically. Plasma CA19 9, CA2 42, CA5 0 and CEA levels were detected by ELISA. Mutations of k ras gene were detected by PCR RFLP and were compared with 11 patients with benign pancreatic diseases. Results: The mutation rate of k ras gene in pancreatic cancer patients was 73.7%. There was no mutation in k ras gene in pancreatic benign disease. The sensitivity and specificity of k ras gene mutation detection were 6 1.9% and 100%, respectively. The sensitivity and specificity of k ras, CA19 9 and CA2 42 detection were 85.7% and 71.9% respectively. Conclusion: The combined detection of plasma k ras gene and tumor markers can improve the diagnostic sensitivity of pancreatic cancer, which has certain clinical significance for screening, diagnosis and differential diagnosis of pancreatic cancer.