Significance of K-ras codon 12 point mutation in pancreatic juice in the diagnosis of carcinoma of the pancreas

The significance of K-ras codon 12 point mutation in pancreatic juice in th e diagnosis of carcinoma of the pancreas is still unclear. The aim of this study was to evaluate the significance of K-ras codon 12 point mutation in pancreatic juice in the diagnosis of carcinoma of the pancreas. All of the 78 reports written from 1988 to 1996 on K-ras point mutation of carcinoma, mucin-producing tumors, and hyperplastic epithelia of the pancreas in both surgical or autopsy specimens and pancreatic juice are reviewed. As results , in surgical or autopsy specimens, K-ras mutation was found in 81% of ordi nary duct cell carcinoma and in 53% of mucin-producing tumor of the pancrea s; this mutation was also found in hyperplastic epithelia in chronic pancre atitis (7%) and in autopsy cases without pancreatic diseases. In pancreatic juice, K-ras mutation was found in 72% of ordinary pancreatic carcinoma an d in 53% of mucin-producing tumor, respectively. In conclusion, most previo us reports have indicated that K-ras mutation in pancreatic juice is useful for a diagnosis of pancreatic carcinoma. However, since K-ras gene mutatio n was also detected in non-tumorous lesions, the diagnosis of pancreatic ca rcinomas is not necessarily correct if it is based solely on the detection of K-ras mutation in pancreatic juice. Future studies should focus on analy zing the amino acid sequence of K-ras mutation or the combination of this m utation with other parameters such as tumor markers in pancreatic juice, to enhance its specificity and accuracy.