title: Significance of K-ras mutation and CEA level in pancreatic juice in the diagnosis of pancreatic cancer.
abstract: The early diagnosis of pancreatic carcinoma is essential for increasing patient survival rates. In this study, 52 patients with suspected pancreatic diseases were examined to investigate the value of K-ras codon 12 point mutation, levels of carcinoembryonic antigen (CEA) and carbohydrate antigen (CA19-9), and cytology of pancreatic juice in the diagnosis of pancreatic carcinoma. Pancreatic juice was taken without secretin stimulation. K-ras mutation was detected by enriched polymerase chain reaction (PCR) restriction fragment length polymorphism (RFLP). K-ras mutation in pancreatic juice was more frequent in carcinoma than in benign diseases (P = 0.0448). The positive predictive value of K-ras mutation for the diagnosis of neoplastic disease was 83%. The CEA level in pancreatic juice in carcinoma was significantly greater than that in benign disease (P< 0.0001). When the cutoff level of CEA was set at 50 ng/ml, its accuracy for the diagnosis of carcinoma was 85%. A multivariate analysis showed that K-ras mutation and CEA level in pancreatic juice, as well as serum CA19-9 level and age of the patient were independent variables for the diagnosis of carcinoma, and the accuracy of diagnosis by this analysis was increased to 90%. In conclusion, both K-ras mutation and CEA level in pancreatic juice may be valuable for the diagnosis of carcinoma. Better discrimination was possible with a multivariate analysis.
authors.affiliation: Department of Surgical Oncology, Faculty of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Futakawa
authors.forename: W
authors.initials: W
authors.lastname: Kimura
authors.forename: S
authors.initials: S
authors.lastname: Yamagata
authors.forename: B
authors.initials: B
authors.lastname: Zhao
authors.forename: H
authors.initials: H
authors.lastname: Ilsoo
authors.forename: T
authors.initials: T
authors.lastname: Inoue
authors.forename: N
authors.initials: N
authors.lastname: Sata
authors.forename: Y
authors.initials: Y
authors.lastname: Kawaguchi
authors.forename: Y
authors.initials: Y
authors.lastname: Kubota
authors.forename: T
authors.initials: T
authors.lastname: Muto
mesh_terms: D000328:Adult; D000368:Aged; D001483:Base Sequence; D014408:Biomarkers, Tumor / Q000032:analysis*; D002272:Carcinoembryonic Antigen / Q000032:analysis*; D002277:Carcinoma / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D005260:Female; D011905:Genes, ras; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010189:Pancreatic Juice / Q000737:chemistry; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D017354:Point Mutation; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen