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- Title
Early Detection of Pancreatic Cancer in Patients With Chronic Pancreatitis: Diagnostic Utility of a K-ras Point Mutation in the Pancreatic Juice.
- Authors
Queneau, Pierre-Edouard; Adessi, Gérard-Louis; Thibault, Pascal; Cléau, Denis; Heyd, Bruno; Mantion, Georges; Carayon, Pierre
- Abstract
OBJECTIVE: Point mutations of the K-<em>ras</em> oncogene at codon 12 have been described several months before the onset of pancreatic cancer in isolated cases of chronic pancreatitis (CP). The aim of this study was to evaluate the interest of a prospective follow-up of patients with CP and K-<em>ras</em> mutations at codon 12 in the detection of early pancreatic cancer. METHODS: From February 1996 to March 1998, 36 patients (mean age 52.6 yr, 31 men, five women) with CP (alcoholic: 61.1%, pancreas divisum: 5.6%, autoimmune: 5.6%, unknown origin: 27.7%) were included and then prospectively monitored (median duration of 22 months) for detection of pancreatic carcinoma. K-<em>ras</em> point mutations were examined by two-step polymerase chain reaction combined with restriction enzyme digestion in pancreatic juice collected during endoscopic retrograde pancreatography. RESULTS: Ten patients (27.8%) were positive for K-<em>ras</em> mutation. Patients with and without the mutation were not different with respect to age and sex ratio. K-<em>ras</em> mutations were homogeneously distributed according to the etiology (alcoholic <em>vs</em> nonalcoholic) and morphological characteristics (ductal stricture or mass <em>vs</em> none) of CP. A pancreatic carcinoma was discovered at an invasive stage in two patients, respectively at 7 and 17 months after disclosure of a K-<em>ras</em> mutation, <em>versus</em> none in patients without the mutation (<em>p</em> < 0.02). CONCLUSIONS: Presence of a K-<em>ras</em> gene mutation is not rare in patients with CP and represents an increased risk of developing pancreatic cancer. However, its utility for the detection of early pancreatic cancer remains doubtful in clinical practice.
- Subjects
PANCREATITIS; CANCER; DNA restriction enzymes; PANCREATIC secretions; POLYMERASE chain reaction
- Publication
American Journal of Gastroenterology (Springer Nature), 2001, Vol 96, Issue 3, p700
- ISSN
0002-9270
- Publication type
Article
- DOI
10.1111/j.1572-0241.2001.03608.x