Clinical validity of detecting K-ras mutations for the diagnosis of exocrine pancreatic cancer: a prospective study in a clinically-relevant spectrum of patients
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Lucy A. Parker Miquel Porta Blanca Lumbreras Toma`s Lo´pez Luisa Guarner Ildefonso Herna´ndez-Aguado Alfredo Carrato Josep M. Corominas
- چاپ و سال / کشور: 2011
Description
The diagnostic utility of detecting K-ras mutations for the diagnosis of exocrine pancreatic cancer (EPC) has not been properly studied, and few reports have analysed a clinically relevant spectrum of patients. The objective was to evaluate the clinical validity of detecting K-ras mutations in the diagnosis of EPC in a large sample of clinically relevant patients. We prospectively identified 374 patients in whom one of the following diagnoses was suspected at hospital admission: EPC, chronic pancreatitis, pancreatic cysts, and cancer of the extrahepatic biliary system. Mutations in the K-ras oncogene were analysed by PCR and artificial RFLP in 212 patients. The sensitivity and specificity of the K-ras mutational status for the diagnosis of EPC were 77.7% (95% CI: 69.2–84.8) and 78.0% (68.1–86.0), respectively. The diagnostic accuracy was hardly modified by sex and age. In patients with either mutated K-ras or CEA[5 ng/ml, the sensitivity and specificity were 81.0% (72.9–87.6) and 62.6% (72.9–87.6), respectively. In patients with mutated K-ras and CEA[5 ng/ml the sensitivity was markedly reduced. In comparisons with a variety of non-EPC patient groups sensitivity and specificity were both always greater than 75%. In this clinically relevant sample of patients the sensitivity and specificity of K-ras mutations were not sufficiently high for independent diagnostic use. However, it seems premature to rule out the utility of K-ras analysis in conjunction with other genetic and ‘omics’ technologies
Eur J Epidemiol (2011) 26:229–236 DOI 10.1007/s10654-011-9547-8 Received: 26 July 2010 / Accepted: 20 January 2011 / Published online: 6 February 2011
