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[目的]建立纳米捕获探针体系检测血浆中K-ras基因突变的方法,并探讨K-ras基因单核苷酸多态性突变与胰腺癌根治术后复发及预后的关系。[方法]收集2013年1月至2016年1月收治的胰腺癌根治性切除患者51例,抽提外周血DNA,应用特异性纳米捕获探针检测K-ras基因12、13位点密码子突变,通过Kaplan-Meier生存分析,评估K-ras基因点突变对胰腺癌根治术后复发及预后的影响。[结果]51例胰腺癌根治术患者基因突变率为35.3%(18/51),K-ras突变与淋巴结转移、神经侵犯有显著性相关(P=0.002、P=0.004)。通过随访分析K-ras基因突变者1年、2年累积无瘤生存率为41.3%、0%,K-ras基因野生型1年、2年累积无瘤生存率为66.3%、14.4%,差异有统计学意义(P=0.042、P=0.008);K-ras基因突变者1年累积总体生存率为81.1%,野生型为93.5%,差异无统计学意义(P=0.203),而K-ras基因突变者2年累积总体生存率为11.7%,野生型为26.4%,差异有统计学意义(P=0.035)。[结论]纳米捕获探针体系能够快速痕量检测血浆中K-ras基因突变,其与胰腺癌的淋巴结转移、神经侵犯密切相关,可作为判断胰腺癌根治术后患者无瘤生存期的ー个重要指标。
[Objective] To establish a method for detecting K-ras gene mutation in plasma by nano-capture probe system and to explore the relationship between K-ras gene single nucleotide polymorphism mutation and recurrence and prognosis of pancreatic cancer after radical operation. [Methods] Totally 51 patients with radical resection of pancreatic cancer who were treated from January 2013 to January 2016 were enrolled. Peripheral blood DNA was extracted and the codon mutations at positions 12 and 13 of K-ras gene were detected by specific nano-capture probe Kaplan-Meier survival analysis was performed to evaluate the effect of K-ras point mutation on the recurrence and prognosis of patients with pancreatic cancer after radical resection. [Results] The gene mutation rate in 51 patients with pancreatic cancer was 35.3% (18/51). There was a significant correlation between K-ras mutation and lymph node metastasis and nerve invasion (P = 0.002, P = 0.004). The follow-up analysis of K-ras gene mutations at 1 year, 2-year cumulative tumor-free survival rate was 41.3%, 0%, K-ras gene wild type 1 year, 2-year cumulative tumor-free survival rate was 66.3%, 14.4% (P = 0.042, P = 0.008). The overall 1-year overall survival rate of K-ras gene mutation was 81.1% and that of wild type was 93.5%, with no significant difference (P = 0.203) The 2-year cumulative overall survival rate of ras gene mutation was 11.7%, wild-type was 26.4%, the difference was statistically significant (P = 0.035). [Conclusion] The nano-capture probe system can rapidly and trace detect the K-ras gene mutation in plasma, which is closely related to the lymph node metastasis and nerve invasion of pancreatic cancer, which can be used as a marker to determine the survival-free period of patients after radical resection of pancreatic cancer Important indicators.