DETECTION OF POINT MUTATIONS IN THE K-RAS ONCOGENE AT CODON-12 IN PURE PANCREATIC-JUICE FOR DIAGNOSIS OF PANCREATIC-CARCINOMA

Background. Mutations in the K-ras oncogene at codon 12 are detected a t a remarkably high frequency in pancreatic carcinomas and are believe d to be a critical event in oncogenesis. The authors attempted to dete ct Kras mutations in DNA obtained from pure pancreatic juice collected endoscopically, as a novel diagnostic approach to pancreatic carcinom a. Methods. K-ras mutations were examined using the two-step polymeras e chain reaction (PCR) combined with restriction enzyme digestion, fol lowed by nonradioisotopic single-strand conformation polymorphism (SSC P) analysis. Results. Specific mutations of the K-ras gene at codon 12 were found in six of nine (67%) duct cell carcinomas, all of which we re negative by cytodiagnosis of the same pure pancreatic juice. K-ras mutations were not detected in the pancreatic juice from 14 healthy co ntrol subjects, 10 patients with chronic pancreatitis, or 3 patients w ith islet cell tumors. Conclusions. Detection of K-ras mutation at cod on 12 in pancreatic juice is highly specific for diagnosing pancreatic duct cell carcinoma and may he a valuable diagnostic modality for pan creatic carcinoma and for differentiating chronic pancreatitis from ca rcinoma.