Telomerase activity in pure pancreatic juice for the diagnosis of pancreatic cancer may be complementary to K-ras mutation

Background: The usefulness of K-ras mutation in pancreatic juice for the di agnosis of pancreatic cancer is questionable. Telomerase is positive in pan creatic cancer but rarely in benign pancreatic diseases. We conducted this study to determine the usefulness of K-ras mutation and telomerase activity in pancreatic juice for the diagnosis of pancreatic cancer. Methods: Pancreatic juice collected during endoscopic retrograde cholangiop ancreatography was examined in 31 patients: 12 with pancreatic cancer, 11 w ith chronic pancreatitis, and 8 control patients. The K-ras gene was detect ed by using the restriction fragment length polymorphism method. Telomerase activity was detected by using the telomeric repeat amplification protocol . Results: K-ras mutation was positive in 75% (9 of 12) of pancreatic cancers and in 27% (3 of II) of cases of chronic pancreatitis but in none of the c ontrol patients. Telomerase activity was detected in 92% (11 of 12) of panc reatic cancers and in 18% (2 of Il)of cases of chronic pancreatitis. The di agnostic value in pancreatic cancer was comparable between K-ras mutation a nd telomerase when evaluated separately. However, by combining these 2 meth ods, the specificity rose to 100%. Conclusions: For the diagnosis of pancreatic cancer, telomerase activity in pancreatic juice may possibly be complementary to K-ras mutation because i t may decrease the rate of false-positive diagnosis.