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

Lucy A. Parker, Miquel Porta, Blanca Lumbreras, Tomàs López, Luisa Guarner, Ildefonso Hernández-Aguado, Alfredo Carrato, Josep M. Corominas, Juli Rifà, Esteve Fernandez, Joan Alguacil, Núria Malats, Francisco X. Real

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13 Citations (Scopus)

Abstract

The diagnostic utility of detecting K-ras 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-ras 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-ras oncogene were analysed by PCR and artificial RFLP in 212 patients. The sensitivity and specificity of the K-ras 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-ras 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-ras 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-ras mutations were not sufficiently high for independent diagnostic use. However, it seems premature to rule out the utility of K-ras analysis in conjunction with other genetic and 'omics' technologies. © Springer Science+Business Media B.V. 2011.
Original languageEnglish
Pages (from-to)229-236
JournalEuropean Journal of Epidemiology
Volume26
Issue number3
DOIs
Publication statusPublished - 1 Mar 2011

Keywords

  • Diagnosis/analysis
  • Diagnosis/diagnostic use
  • Diagnosis/methods
  • Epidemiology/diagnosis
  • Genes, ras
  • KRAS oncogene
  • Oncogene protein p21 ras
  • Pancreatic neoplasms/diagnosis
  • Research/methods

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