BACKGROUND & AIMS:
:The present study aimed to investigate the feasibility and effectiveness of detecting K-ras mutation by using magnetic nanoparticles in fecal samples of patients with pancreatic cancer at different stages. The novel methodology of K-ras mutation detection was compared to the existing methodology of cancer antigen (CA)19-9 examination. Patients with pancreatic cancer (n=88), pancreatic benign diseases who displayed chronic pancreatitis (n=35), pancreatic mucinous cyst neoplasms (n=10) and pancreatic serous cyst (n=9) admitted to the Department of Surgery, Jiaxing Second Hospital were enrolled in the present study. Fecal samples were collected from all patients, DNA was extracted and magnetic nanoprobe was then used to detect K-ras mutation. The results obtained using the novel magnetic nanoprobe detection technique showed a K-ras mutation rate of 81.8% (72/88) in the patients with pancreatic cancer and 18.5% (10/54) in patients with pancreatic benign diseases. In patients with pancreatic cancer, the K-ras mutation rate was comparable in stages I + IIA and IIB + III + IV (78.9 vs. 84.0%; P>0.05). The sensitivity and specificity of K-ras mutation for detection of pancreatic cancer was 81.8 and 81.5%, respectively. Sixty-eight pancreatic cancer patients had >37 U/ml CA99 with a sensitivity and specificity for pancreatic cancer detection of 77.3 and 77.8%, which was not significantly lower than detection by the fecal K-ras mutations (P>0.05). Combinational detection of fecal K-ras mutations and serum CA19-9 significantly increased the sensitivity regarding pancreatic cancer detection to 97.7% (P<0.05), while the specificity was not enhanced (80.9%; P>0.05) compared with fecal K-ras mutations or CA19-9 alone. The findings showed that the magnetic nanoprobe is able to detect fecal K-ras mutations in different stages of pancreatic cancer, with comparable sensitivity and specificity to CA19-9 examination for differentiating pancreatic cancer. Furthermore, combined detection of CA19-9 and K-ras mutations has enhanced sensitivity compared with CA19-9 alone.
背景与目标:
: 本研究旨在探讨磁性纳米颗粒在不同阶段的胰腺癌患者粪便中检测K-ras突变的可行性和有效性。将新的K-ras突变检测方法与现有的癌症抗原 (CA)19-9检查方法进行了比较。本研究纳入嘉兴市第二医院外科收治的胰腺癌 (n = 88),表现为慢性胰腺炎 (n = 35) 的胰腺良性疾病,胰腺粘液性囊肿 (n = 10) 和胰腺浆液性囊肿 (n = 9)。收集所有患者的粪便样本,提取DNA,然后使用磁性纳米探针检测K-ras突变。使用新型磁性纳米探针检测技术获得的结果显示,胰腺癌患者的K-ras突变率为81.8% (72/88),胰腺良性疾病患者的18.5% (10/54)。在胰腺癌患者中,K-ras突变率在I + IIA和IIB + III + IV期相当 (78.9对84.0%; P>0.05)。K-ras突变检测胰腺癌的敏感性和特异性分别为81.8和81.5%。68例胰腺癌患者的CA99> 37 U/ml,对胰腺癌检测的敏感性和特异性为77.3和77.8%,不明显低于粪便K-ras突变的检测 (P>0.05)。粪便K-ras突变和血清CA19-9的组合检测显著提高了胰腺癌检测的敏感性至97.7% (P<0.05),而特异性与粪便K-ras突变或单独CA19-9相比没有增强 (80.9%; P>0.05)。研究结果表明,磁性纳米探针能够检测胰腺癌不同阶段的粪便K-ras突变,与CA19-9鉴别胰腺癌的检查具有相当的敏感性和特异性。此外,与单独CA19-9相比,CA19-9和K-ras突变的联合检测具有增强的敏感性。