山东医药
山東醫藥
산동의약
Shandong Medical Journal
2015年
44期
4-7
,共4页
肝外胆管癌%胆管良性狭窄%胆汁%p53基因%K-ras基因
肝外膽管癌%膽管良性狹窄%膽汁%p53基因%K-ras基因
간외담관암%담관량성협착%담즙%p53기인%K-ras기인
extrahepatic cholangiocarcinoma%benign bile duct stricture%bile%p53 gene%K-ras gene
目的：检测肝外胆管癌患者胆汁上清液及沉淀物中K-ras、p53基因突变情况，探讨其意义。方法选取肝外胆管癌患者57例、胆管良性狭窄患者42例，均收集并提取胆汁上清液及沉淀物标本，采用PCR-SSCP银染法和DNA直接测序法分析K-ras和p53基因突变情况。结果胆管良性狭窄患者胆汁上清液及沉淀物标本均未发现K-ras、p53基因突变。胆管癌患者胆汁中K-ras基因突变率为77．19％（44／57），其中上清液为66．67％（38／57）、沉淀物为59．65％（34／57），两者比较P＞0．05；p53基因突变率为70．18％（40／57），其中上清液为63．16％（36／57）、沉淀物为45．61％（26／57），两者比较P＜0．05。胆管癌患者胆汁上清液和沉淀物中p53基因和K-ras基因突变联合检测突变率为85．97％（49／57）。结论肝外胆管癌患者胆汁上清液及沉淀物中均检测到K-ras、p53基因突变，且联合检测阳性率更高；胆汁K-ras、p53基因突变检测可用于肝外胆管癌与胆管良性狭窄的鉴别诊断。
目的：檢測肝外膽管癌患者膽汁上清液及沉澱物中K-ras、p53基因突變情況，探討其意義。方法選取肝外膽管癌患者57例、膽管良性狹窄患者42例，均收集併提取膽汁上清液及沉澱物標本，採用PCR-SSCP銀染法和DNA直接測序法分析K-ras和p53基因突變情況。結果膽管良性狹窄患者膽汁上清液及沉澱物標本均未髮現K-ras、p53基因突變。膽管癌患者膽汁中K-ras基因突變率為77．19％（44／57），其中上清液為66．67％（38／57）、沉澱物為59．65％（34／57），兩者比較P＞0．05；p53基因突變率為70．18％（40／57），其中上清液為63．16％（36／57）、沉澱物為45．61％（26／57），兩者比較P＜0．05。膽管癌患者膽汁上清液和沉澱物中p53基因和K-ras基因突變聯閤檢測突變率為85．97％（49／57）。結論肝外膽管癌患者膽汁上清液及沉澱物中均檢測到K-ras、p53基因突變，且聯閤檢測暘性率更高；膽汁K-ras、p53基因突變檢測可用于肝外膽管癌與膽管良性狹窄的鑒彆診斷。
목적：검측간외담관암환자담즙상청액급침정물중K-ras、p53기인돌변정황，탐토기의의。방법선취간외담관암환자57례、담관량성협착환자42례，균수집병제취담즙상청액급침정물표본，채용PCR-SSCP은염법화DNA직접측서법분석K-ras화p53기인돌변정황。결과담관량성협착환자담즙상청액급침정물표본균미발현K-ras、p53기인돌변。담관암환자담즙중K-ras기인돌변솔위77．19％（44／57），기중상청액위66．67％（38／57）、침정물위59．65％（34／57），량자비교P＞0．05；p53기인돌변솔위70．18％（40／57），기중상청액위63．16％（36／57）、침정물위45．61％（26／57），량자비교P＜0．05。담관암환자담즙상청액화침정물중p53기인화K-ras기인돌변연합검측돌변솔위85．97％（49／57）。결론간외담관암환자담즙상청액급침정물중균검측도K-ras、p53기인돌변，차연합검측양성솔경고；담즙K-ras、p53기인돌변검측가용우간외담관암여담관량성협착적감별진단。
Objective To detect the K-ras and p53 gene mutations both in the supernatant and sediment of bile sam-ples from patients with extrahepatic cholangiocarcinoma ( EHC) and to investigate its significance .Methods Fifty-seven patients with EHC and 42 patients with benign bile duct stricture were surveyed .The supernatant and sediment in their bile was collected by duodenal endoscopy .Polymerase chain reaction-single-strand conformation polymorphism ( PCR-SSCP ) and DNA direct sequencing were performed to detect K-ras mutations and p53 mutations both in the supernatant and sedi-ment of bile samples .Results No gene mutations were detected in 42 patients with benign bile duct stricture in either su-pernatant or sediment of bile .The mutation rate of K-ras gene of patients with EHC was 77.19%(44/57), 66.67%(38/57) in the bile supernatant and 59.65%(34/57) in the corresponding sediment, respectively (P>0.05).The mutation rate of p53 gene of patients with EHC was 70.18% (40/57), 63.16% (36/57) in the bile supernatant and 45.61%(25/57) in the corresponding sediment, respectively (P<0.05).The total mutation rate of combined K-ras and p53 genes in the supernatant and sediment of bile samples from patients with EHC was 85.97%(49/57).Conclusions K-ras and p53 mutations were detected both in the supernatant and sediment of bile from patients with EHC .The combined detec-tion of K-ras and p53 mutations improved the positive rate .The detection of K-ras and p53 mutations may be used in the differential diagnosis of extrahepatic cholangiocarcinoma and benign bile duct stricture .
