Clinical validity of detecting K-ras mutations for the diagnosis of exocrine pancreatic cancer: a prospective study in a clinically-relevant spectrum of patients

Autor: Francisco X. Real, Miquel Porta, Joan Alguacil, Núria Malats, Ildefonso Hernández-Aguado, Blanca Lumbreras, Lucy Anne Parker, Esteve Fernández, Juli Rifà, Luisa Guarner, Alfredo Carrato, Tomàs López, Josep M. Corominas
Přispěvatelé: Department of Public Health, Miguel Hernández University, CIBER en Epidemiología y Salud Pública (CIBERESP), CIBER de Epidemiología y Salud Pública (CIBERESP), Facultat de Medicina, Universitat Autònoma de Barcelona (UAB), IMIM-Hospital del Mar, Generalitat de Catalunya, Vall d'Hebron University Hospital [Barcelona], Hospital Universitario Ramón y Cajal [Madrid], Universidad de Alcalá - University of Alcalá (UAH), Hospital Son Dureta, Catalan Institute of Oncology (ICO), Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), University of Barcelona, Universidad de Huelva, Centro Nacional de Investigaciones Oncológicas, Universitat Pompeu Fabra [Barcelona] (UPF)
Rok vydání: 2011
Předmět:
Male
medicine.medical_specialty
Pathology
Pancreatic disease
Epidemiology
Diagnosis/analysis
Polymerase Chain Reaction
Sensitivity and Specificity
Gastroenterology
Epidemiology/diagnosis
03 medical and health sciences
0302 clinical medicine
Internal medicine
Diagnosis/diagnostic use
medicine
Humans
Oncogene protein p21 ras
Prospective Studies
030212 general & internal medicine
Medical diagnosis
Prospective cohort study
KRAS oncogene
ras
Aged
Aged
80 and over
business.industry
Reproducibility of Results
Cancer
Middle Aged
medicine.disease
Omics
Pancreatic neoplasms/diagnosis
3. Good health
Pancreatic Neoplasms
Diagnosis/methods
Genes
ras
Genes
030220 oncology & carcinogenesis
Mutation
Pancreatitis
Exocrine pancreatic cancer
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
Female
Pancreatic cysts
business
Research/methods
Polymorphism
Restriction Fragment Length
Zdroj: European Journal of Epidemiology
European Journal of Epidemiology, Springer Verlag, 2011, 26 (3), pp.229-236. ⟨10.1007/s10654-011-9547-8⟩
ISSN: 1573-7284
0393-2990
DOI: 10.1007/s10654-011-9547-8
Popis: International audience; The diagnostic utility of detecting K- mutations for the diagnosis of exocrine pancreatic cancer (EPC) has not been properly studied, and few reports have analysed a clinically relevant spectrum of patients. The objective was to evaluate the clinical validity of detecting K- mutations in the diagnosis of EPC in a large sample of clinically relevant patients. We prospectively identified 374 patients in whom one of the following diagnoses was suspected at hospital admission: EPC, chronic pancreatitis, pancreatic cysts, and cancer of the extrahepatic biliary system. Mutations in the K- oncogene were analysed by PCR and artificial RFLP in 212 patients. The sensitivity and specificity of the K- mutational status for the diagnosis of EPC were 77.7% (95% CI: 69.2-84.8) and 78.0% (68.1-86.0), respectively. The diagnostic accuracy was hardly modified by sex and age. In patients with either mutated K- or CEA > 5 ng/ml, the sensitivity and specificity were 81.0% (72.9-87.6) and 62.6% (72.9-87.6), respectively. In patients with mutated K- and CEA > 5 ng/ml the sensitivity was markedly reduced. In comparisons with a variety of non-EPC patient groups sensitivity and specificity were both always greater than 75%. In this clinically relevant sample of patients the sensitivity and specificity of K- mutations were not sufficiently high for independent diagnostic use. However, it seems premature to rule out the utility of K- analysis in conjunction with other genetic and 'omics' technologies.
Databáze: OpenAIRE
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