Detection of K-ras and p53 gene mutations in pancreatic juice for the diagnosis of intraductal papillary mucinous tumors

The aim of this study was to investigate mutations of the K-rns oncogene an d the p53 turner suppressor gene in pancreatic juice and to evaluate our me thod for the diagnosis of intraductal papillary mucinous tumors (IPMT). Pan creatic juice was collected endoscopically from 12 patients with IPMT who u nderwent surgical resection (eight carcinomas and four adenomas) and eight cases without evident pancreatic diseases, DNA was extracted and both genes were examined by polymerase chain reaction single-strand conformation poly morphism (PCR-SSCP) analysis and direct sequencing. In addition, surgically resected specimens were analyzed for both genes by the same methods, and p 53 overexpression was investigated immunohistochemically. K-ras point mutat ions were detected in pancreatic juice from all 12 patients (100%) and p53 mutations were detected in five of 12 (42%). They were detected not only in carcinoma but also in adenoma and there was no difference between the muta tions detected in pancreatic juice and surgical specimens. No mutations wer e found in any cases without pancreatic diseases. These findings suggest th at alterations of K-ras and p53 gene are common events in the development o f IPMT and that genetic analysis of them in pancreatic juice can be a usefu l tool for the clinical diagnosis of IPMT before surgery.