论文部分内容阅读
目的 检测胰腺癌和慢性胰腺炎患者胰液中K ras基因突变和端粒酶活性 ,探讨端粒酶活性与K ras基因突变联合检测对胰腺癌患者诊断价值。方法 收集 2 4例胰腺癌和 14例慢性胰腺炎患者胰液 ,K ras基因突变采用聚合酶链反应 -限制性酶切片段长度多态性 ( polymerasechianreaction -restrictionfragmentlengthpolymorphism ,PCR -RFLP)检测 ,端粒酶活性检测采用端粒末端重复序列扩增技术 (telomericrepeatamplificationprotocol ,TRAP)。 结果 胰腺癌中K ras基因突变率为 87.5 % ( 2 1/2 4) ,慢性胰腺炎中K ras基因突变率仅为 2 1.3 % ( 3 /14 ) ,差异有显著性 (P<0 .0 1) ;在 2 4例胰腺癌中端粒酶阳性检出率为 83 .3 % ( 2 0 /2 4) ;而 14例慢性胰腺炎胰液中端粒酶阳性检出率为 2 8.6% ( 4 /2 4) ,差异同样具有显著性 (P <0 .0 1)。K ras基因突变与端粒酶活性检测诊断胰腺癌的特敏感性分别为 87.5 % ,83 .3 % ;两者联合检测诊断胰腺癌的敏感性为 85 .5 % ,特异性达到 85 .7%。结论 联合检测胰液中K ras基因与端粒酶活性可提高胰腺癌诊断的敏感性和特异性 ,对胰腺癌筛查、诊断与鉴别诊断有一定临床意义
Objective To detect K ras gene mutation and telomerase activity in pancreatic juice and pancreatic juice in patients with pancreatic cancer and to explore the diagnostic value of telomerase activity and K ras gene mutation in pancreatic cancer patients. Methods Pancreatic juice was collected from 24 patients with pancreatic cancer and 14 patients with chronic pancreatitis. The K ras gene mutation was detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The telomerase activity Detection using telomeric repeat amplification protocol (telomeric repeatamplificationprotocol, TRAP). Results The rate of K ras gene mutation in pancreatic cancer was 87.5% (2 1/2 4), and the rate of K ras gene mutation in chronic pancreatitis was only 2 1.3% (3/14) (P <0. 0 1). The positive rate of telomerase in 24 cases of pancreatic cancer was 83.3% (20/24). The positive rate of telomerase in pancreatic juice from 14 patients with chronic pancreatitis was 22.6% ( 4/2 4), the difference was also significant (P <0.01). The sensitivity of detecting K ras gene mutation and telomerase activity in detecting pancreatic cancer was 87.5% and 83.3% respectively. The sensitivity and specificity of the combined detection of K ras gene and telomerase activity in the diagnosis of pancreatic cancer were 85.5% and 85.7% . Conclusions Combined detection of K ras gene and telomerase activity in pancreatic juice can improve the sensitivity and specificity of pancreatic cancer diagnosis and has certain clinical significance for screening, diagnosis and differential diagnosis of pancreatic cancer