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目的探讨胆汁中K-ras基因突变检测在胰腺癌肝转移早期诊断中的价值。方法通过建立胰腺癌及胰腺癌肝转移的大鼠动物模型,收集模型大鼠的胆汁,采用聚合酶链反应-限制性片段长度多态性分析(PCR-RFLP)检测胆汁中K-ras基因12密码子点突变情况并与病理切片法相比较。结果16例胰腺癌动物模型胆汁标本中无K-ras基因突变(0/16),19例胰腺癌肝转移动物模型胆汁标本中K-ras基因突变率为84.20%(16/19)。胰腺癌肝转移胆汁K-ras基因突变检测的敏感性为84.20%,特异性为85.7%,阳性预测值为84.20%,阴性预测值为85.70%。结论胰腺癌肝转移胆汁中K-ras基因可以发生突变,其突变率高,特异性强,可能为胰腺癌肝转移早期诊断的初步筛选提供新的方法。
Objective To investigate the value of K-ras gene mutation in the diagnosis of early liver metastasis of pancreatic cancer. Methods The animal model of pancreatic cancer and hepatic metastasis of pancreatic cancer was established and the bile of rats were collected. The expression of K-ras gene 12 in bile was detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) Codon point mutation and compared with the biopsy. Results No K-ras gene mutation (0/16) was found in 16 pancreatic cancer animal models. The mutation rate of K-ras gene was 84.20% (16/19) in 19 cases of pancreatic cancer with liver metastasis. The sensitivity of K-ras gene mutation detection in pancreatic cancer with liver metastasis was 84.20%, specificity was 85.7%, positive predictive value was 84.20%, and negative predictive value was 85.70%. Conclusions The K-ras gene in liver metastasis of pancreatic cancer may be mutated and its mutation rate is high and specificity is high. It may provide a new method for the preliminary screening of early diagnosis of liver metastasis of pancreatic cancer.