A prospective study of detection of pancreatic carcinoma by combined plasma K-ras mutations and serum CA19-9 analysis

Previous studies have demonstrated the possibility of detecting K mutations in the plasma of patients with pancreatic carcinoma. To investigate the diagnostic value of combined plasma K mutations with serum CA19-9 in patients with pancreatic carcinoma. The study included 58 consecutive patients with suspected pancreatic masses and 21 healthy controls. DNA was extracted from plasma. Point mutation at codon 12 of K gene was analyzed by means of the enriched polymerase chain reaction-restriction fragment length polymorphism technique. No mutated K codon 12 was detected in the plasma DNA from the 21 healthy controls. Mutations of K codon 12 were found in plasma DNA samples from 29 (70.7%) of 41 patients with pancreatic carcinoma. Elevated CA19-9 was found in 30 (73.2%) of 41 pancreatic cancer patients. In total, 37 of 41 (90.2%) patients with pancreatic carcinoma tested positive by either method. Mutated K was also found in 3 patients and elevated CA19-9 in 8 of the 17 patients with other lesions in the pancreatic area. The results indicate that plasma K mutation analysis combined with serum CA19-9 determination could detect the majority of cases of pancreatic carcinoma.