Differential diagnosis between chronic pancreatitis and pancreatic cancer: value of the detection of KRAS2 mutations in circulating DNA View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2002-08-27

AUTHORS

F Maire, S Micard, P Hammel, H Voitot, P Lévy, P-H Cugnenc, P Ruszniewski, P Laurent Puig

ABSTRACT

KRAS2 mutations in codon 12 have been detected in about 80% of pancreatic cancers. The aim of this study was to evaluate the value of KRAS2 mutations detection in circulating deoxyribo nucleic acid to differentiate pancreatic cancer from chronic pancreatitis. Circulating deoxyribonucleic acid was isolated from serum in 47 patients with histologically proven pancreatic adenocarcinomas (26 males, median age 65 years) and 31 controls with chronic pancreatitis (26 males, median age 48 years). Mutations at codon 12 of KRAS2 gene were searched for using polymerase chain reaction and allele specific amplification. Serum carbohydrate antigen 19.9 levels were also determined. KRAS2 mutations were found in 22 patients (47%) with pancreatic cancer and in four controls with chronic pancreatitis (13%) (P<0.002). None of the latter developed a pancreatic cancer within the 36 months of median follow-up. The sensitivity, specificity, positive and negative predictive values of serum serum KRAS2 mutations for the diagnosis of pancreatic cancer were 47, 87, 85 and 52%, respectively. KRAS2 mutations were not related to age, gender, smoking habit, tumour stage, or survival. Among the 26 patients with normal or non-contributive (due to cholestasis) serum carbohydrate antigen 19.9 levels, 14 (54%) had KRAS2 mutations. The combination of KRAS2 and carbohydrate antigen 19.9 gave a sensitivity, specificity, positive and negative predictive values for the diagnosis of pancreatic cancer of 98, 77, 87 and 96%, respectively. Detection of KRAS2 mutations in circulating deoxyribo nucleic acid has a low sensitivity but a specificity about 90% for the diagnosis of pancreatic cancer. It seems particularly useful when serum carbohydrate antigen 19.9 levels are normal or inconclusive. A combined normal serum carbohydrate antigen 19.9 and absence of circulating KRAS2 mutations makes the diagnosis of pancreatic cancer extremely unlikely. More... »

PAGES

551-554

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/sj.bjc.6600475

DOI

http://dx.doi.org/10.1038/sj.bjc.6600475

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1029325429

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/12189555


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35 schema:description KRAS2 mutations in codon 12 have been detected in about 80% of pancreatic cancers. The aim of this study was to evaluate the value of KRAS2 mutations detection in circulating deoxyribo nucleic acid to differentiate pancreatic cancer from chronic pancreatitis. Circulating deoxyribonucleic acid was isolated from serum in 47 patients with histologically proven pancreatic adenocarcinomas (26 males, median age 65 years) and 31 controls with chronic pancreatitis (26 males, median age 48 years). Mutations at codon 12 of KRAS2 gene were searched for using polymerase chain reaction and allele specific amplification. Serum carbohydrate antigen 19.9 levels were also determined. KRAS2 mutations were found in 22 patients (47%) with pancreatic cancer and in four controls with chronic pancreatitis (13%) (P<0.002). None of the latter developed a pancreatic cancer within the 36 months of median follow-up. The sensitivity, specificity, positive and negative predictive values of serum serum KRAS2 mutations for the diagnosis of pancreatic cancer were 47, 87, 85 and 52%, respectively. KRAS2 mutations were not related to age, gender, smoking habit, tumour stage, or survival. Among the 26 patients with normal or non-contributive (due to cholestasis) serum carbohydrate antigen 19.9 levels, 14 (54%) had KRAS2 mutations. The combination of KRAS2 and carbohydrate antigen 19.9 gave a sensitivity, specificity, positive and negative predictive values for the diagnosis of pancreatic cancer of 98, 77, 87 and 96%, respectively. Detection of KRAS2 mutations in circulating deoxyribo nucleic acid has a low sensitivity but a specificity about 90% for the diagnosis of pancreatic cancer. It seems particularly useful when serum carbohydrate antigen 19.9 levels are normal or inconclusive. A combined normal serum carbohydrate antigen 19.9 and absence of circulating KRAS2 mutations makes the diagnosis of pancreatic cancer extremely unlikely.
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42 schema:keywords DNA
43 KRAS2
44 KRAS2 mutations
45 KRAS2 mutations detection
46 Kras2 gene
47 absence
48 acid
49 adenocarcinoma
50 age
51 aim
52 allele specific amplification
53 amplification
54 antigen 19.9
55 antigen 19.9 levels
56 cancer
57 carbohydrate antigen 19.9
58 carbohydrate antigen 19.9 levels
59 chain reaction
60 chronic pancreatitis
61 codon 12
62 combination
63 combination of KRAS2
64 combined normal serum carbohydrate antigen 19.9
65 control
66 deoxyribo nucleic acid
67 deoxyribonucleic acid
68 detection
69 diagnosis
70 differential diagnosis
71 gender
72 genes
73 habits
74 levels
75 low sensitivity
76 months
77 mutation detection
78 mutations
79 negative predictive value
80 non-contributive (due to cholestasis) serum carbohydrate antigen 19.9 levels
81 normal serum carbohydrate antigen 19.9
82 nucleic acids
83 pancreatic adenocarcinoma
84 pancreatic cancer
85 pancreatitis
86 patients
87 polymerase chain reaction
88 predictive value
89 reaction
90 sensitivity
91 serum
92 serum KRAS2 mutations
93 serum carbohydrate antigen 19.9
94 serum carbohydrate antigen 19.9 levels
95 serum serum KRAS2 mutations
96 smoking habits
97 specific amplification
98 specificity
99 stage
100 study
101 survival
102 tumor stage
103 values
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