K-RAS GENE-MUTATIONS IN THE DIAGNOSIS OF FINE-NEEDLE ASPIRATES OF PANCREATIC MASSES - PROSPECTIVE-STUDY USING 2 TECHNIQUES WITH DIFFERENT DETECTION LIMITS

Detection of K-ms mutations may be useful in the evaluation of pancrea tic cancer. The aim of this study was to assess, in a prospective desi gn, the diagnostic utility of K-ras mutation analysis in 62 consecutiv e fine-needle aspirates of pancreatic masses, using two PCR-based tech niques-standard and enriched-with detection limits of a mutant allele in the presence of 10(2) or 10(3) wild-type alleles, respectively. Cyt ology alone offered a diagnostic sensitivity of 75%. The enriched high er sensitivity detection technique, in combination with cytology, offe red a diagnostic sensitivity of 91% without false positives. The molec ular analysis would have contributed to diagnosis in an additional 14 cases of pancreatic cancer. The standard technique contributed to diag nosis in an additional 9 cases. These results strongly support the use of the enriched method of detecting K-uns mutations as a complement t o cytology in the evaluation of pancreatic masses.