Detection of c-Ki-ras gene codon 12 mutations from pancreatic duct brushings in the diagnosis of pancreatic tumours.

摘要: Differential diagnosis of pancreatic cancer and chronic pancreatitis is sometimes difficult cytological examination brushings or aspirated material collected during endoscopic retrograde cholangiopancreatography (ERCP) remains disappointing. As point mutations in codon 12 the c-Ki-ras 2 gene are found most adenocarcinoma not pancreatitis, this study analysed prospectively presence these brushing samples ERCP 45 patients (26 males, 19 females) showing a dominant stricture main duct at pancreatography: 24 with adenocarcinoma, 16 five intraductal mucin hypersecreting neoplasms. Twenty presented equivocal findings that did permit definite diagnosis. Ki-ras were detected using rapid sensitive method based on polymerase chain reaction mediated restriction fragment length polymorphism analysis confirmed by direct sequencing products. Results compared those provided routine brush cytology. A definitive was established for each patient. Mutations 20 (83%), but none neoplasms, irrespective their location. By contrast, only 13 (54%) conventional examination, which yielded four false negative seven non-contributive results. Sensitivity, specificity, accuracy molecular biological methods 83%-76%, 100-83%, 90%-58%, respectively. Notably could be six small tumour size (