title: Clinical significance of K-ras and c-erbB-2 mutations in pancreatic adenocarcinoma and chronic pancreatitis.
abstract: BACKGROUND
  The differentiation of chronic pancreatitis (CP) from pancreatic adenocarcinoma (PA) remains the great challenge for clinicians. The purpose of this study was to compare the prevalence of K-ras and c-erbB-2 mutations in PA and CP in order to evaluate their usefulness in differential diagnosis of those diseases.
  
  
  METHODS
  The study included 49 patients who underwent Whipple resection or distal pancreatectomy for pancreatic adenocarcinoma (26 subjects) or chronic pancreatitis (23 subjects). DNA from pancreatic tissue was analyzed for K-ras codon 12 and c-erbB-2 mutations with PCR amplifications.
  
  
  RESULTS
  The K-ras gene mutation has been shown in 20 (76.9%) PA cases and in 8 (34.8%) CP cases (p<0.01). Prevalence of c-erbB-2 amplification in patients with PA was 17 (65.3%), which was not different from CP, 16 (56.5%) (p=0.58). There was a significant correlation between K-ras mutation and lymph node metastases (p=0.025) as well as between K-ras mutation and G3 tumor differentiation (p=0.037). Overall median survival in patients with PA was 9.5 mo. There was no relationship between presence of K-ras (p=0.58) or c-erbB-2 (p=0.17) mutation and survival time in PA patients.
  
  
  CONCLUSIONS
  Those results may indicate that both K-ras and c-erbB-2 play a role in pancreatic carcinogenesis, however only K-ras may provide an additional tool in differential diagnosis of CP and PC.
authors.affiliation: Department of Digestive Tract Diseases, Medical University, Lodz, Poland. r-wojnarowska@wp.pl
authors.forename: Renata
authors.initials: R
authors.lastname: Talar-Wojnarowska
authors.forename: Anita
authors.initials: A
authors.lastname: Gasiorowska
authors.forename: Beata
authors.initials: B
authors.lastname: Smolarz
authors.forename: Hanna
authors.initials: H
authors.lastname: Romanowicz-Makowska
authors.forename: Janusz
authors.initials: J
authors.lastname: Strzelczyk
authors.forename: Adam
authors.initials: A
authors.lastname: Janiak
authors.forename: Andrzej
authors.initials: A
authors.lastname: Kulig
authors.forename: Ewa
authors.initials: E
authors.lastname: Malecka-Panas
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000235:genetics*; D000328:Adult; D000368:Aged; D002471:Cell Transformation, Neoplastic; D004252:DNA Mutational Analysis; D004273:DNA, Neoplasm / Q000032:analysis; D003937:Diagnosis, Differential; D005260:Female; D018734:Genes, erbB-2 / Q000235:genetics*; D011905:Genes, ras / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000235:genetics*; D010195:Pancreatitis / Q000175:diagnosis* / Q000235:genetics*; D016133:Polymerase Chain Reaction
chemical_list: D004273:DNA, Neoplasm
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