췌장암 및 만성 췌장염 환자에서 경피적 세침 흡인으로 얻은 검체의 K-ras 유전자 변이 검출과 이의 유용성

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. (Kor J Gastroenterol 2000;35:93 - 102)