DETECTION OF C-KI-RAS MUTATIONS IN BILE SAMPLES FROM PATIENTS WITH PANCREATIC AND BILIARY CANCERS

Aim - To determine whether c-Ki-ras mutations can be detected in bile from patients with biliary strictures caused by pancreatic cancer and other biliary tumours, with a view to developing bile c-Ki-ras mutatio ns as a non-invasive diagnostic marker of pancreatic cancer. Methods - Bile was collected from 89 subjects (47 controls (including patients with bile duct stones or benign stricture), 20 patients with pancreati c cancer, 11 with cholangiocarcinoma, five with ampullary cancer, and six with metastatic biliary obstruction) referred for endoscopic retro grade cholangiopancreatography. DNA was extracted from bile and c-Ki-r as codon 12 mutations were detected using PCR and a restriction enzyme digestion method. Results - c-Ki-ras mutations were detected in 10 (5 0%) of 20 patients with pancreatic cancer, in one (9%) of 11 with chol angiocarcinoma, and in two (33%) of six patients with metastatic bilia ry obstruction (primary tumours: colon and prostate). C-Ki-ras mutatio ns were not detected in the controls and patients with ampullary cance r. Conclusions - The sensitivity of this test is too low at 50% to rec ommend its use clinically, but with refinement has potential as a diag nostic marker for pancreatic cancer.