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Second Department of Medicine, Faculty of Medicine, University of Tokyo [M. T., M. Om.], and First Department of Medicine, School of Medicine, Chiba University [S. K., H. S., M. Oh.], Japan, and Department of Human Genetics [R. K. S.] and Infectious Diseases [J. J. S.], Roche Molecular Systems, Inc., Alameda, California 94501
Pancreatic adenocarcinomas are known to have a high incidence of K-ras gene mutations. Differential diagnosis of pancreatic cancer and chronic pancreatitis sometimes presents a clinical dilemma. We recently developed a highly sensitive and specific polymerase chain reaction capable of detecting 3–30 copies of mutant K-ras genes harboring codon 12 single base changes in the presence of 300,000 normal copies. Mutant ras genes were detected in DNA purified from pancreatic juice from all 6 cases of pancreatic adenocarcinoma and 1 case of intraductal papillary neoplasms of the pancreas. In 2 of 6 other cases with pancreatic adenocarcinoma, circulating metastatic cells were detected in DNA purified from peripheral blood. Activated ras genes were not found in pancreatic juice of three control cases (chronic pancreatitis and choledocholithiasis) or in the peripheral blood of two patients with insulinomas. Notable conclusions of this study are that there can be significant levels of shed tumor cells in peripheral blood and an even higher number in pancreatic juice. In addition, two different K-ras mutations were found in some patients.
1 To whom requests for reprints should be addressed, at Roche Molecular Systems, Inc., 1145 Atlantic Avenue, Alameda, CA 94501.
Received 3/16/93. Accepted 4/20/93.
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