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目的 :本研究旨在探讨粪便p5 3基因突变检测方法在胰腺癌诊断中的潜在价值。方法 :对连续就诊的胰腺癌 6 2例患者的粪便 ,采用改进的两阶段酚 -氯仿抽提和高浓度蛋白酶K消化法提取DNA。随后 ,采用PCR SSCP方法检测粪便 p5 3外显子 5～ 8的突变情况。结果 :以测定胰液p5 3突变率作为对照 ,粪便 p5 3检测的敏感性为 0 8,特异性为 0 6 8,准确性为 0 71,阳性预测值为 0 36 ,阴性预测值为 0 94。胰腺癌患者手术切除标本和粪便p5 3突变检测结果一致率为 6 3 6 %( 7/11) ,不一致率为 36 4 %( 4 /11) ,阳性预测值为 0 33,阴性预测值为 0 75。胰腺癌患者粪便 p5 3突变率为 37 1%( 2 3/6 2 ) ,良性消化道疾病为 12 8%( 5 /39) ,正常人为 5 5 %( 3/5 5 )。结论 :粪便p5 3突变检测是一项具有潜在应用价值的对胰腺癌高危人群进行筛查的方法。
Objective: This study aimed to investigate the potential value of stool p5 3 gene mutation detection in the diagnosis of pancreatic cancer. Methods: The faeces of 62 consecutive pancreatic cancer patients were treated with improved two-phase phenol-chloroform extraction and high-concentration proteinase K digestion. Subsequently, the PCR SSCP method was used to detect mutations in exons 5 to 8 of exon 5 of feces. Results: The p5 3 mutation rate of pancreatic juice was used as a control. The sensitivity and specificity of p5 3 in feces assay were 0 8 and 0 6 8 respectively. The accuracy was 0 71, the positive predictive value was 0 36 and the negative predictive value was 0 94. The concordance rate between the resected specimens of pancreatic cancer and those from the stool samples was 6 36% (7/11), the rate of inconsistency was 36 4% (4/11), the positive predictive value was 0 33 and the negative predictive value was 0 75. The mutation rate of stool p5 3 in pancreatic cancer was 37 1% (2 3/6 2), benign digestive tract disease was 12 8% (5/39) and normal human was 5 5% (3/5 5). Conclusion: The detection of stool p5 3 mutation is a potentially useful method for screening patients at high risk of pancreatic cancer.