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Clinical singnificance in diagnosis of biliary tract carcinoma by detection of K-ras、P53 and P16 gene mutations in duodenal juice

XUE Ping, ZHENG Qiang, LU Hai-wu, HU Yi-ze.Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Guangzhou Medical college, GuangZhou 510260, China Corresponding author: HU Yi-ze, E-mail: Huyize@yahoo.com.cn  
Objective To investigate the role of K-ras, P53, and P16 gene of duodenal juice detection in diagnosis of biliary tract carcinoma (BTC). Methods The K-ras, P53 and P16 gene mutations in the bile and duodenal juice from 30 cases with BTC and 10 cases with benign choledocholithiasis were detected by PCR-SSCP-AgNO3 staining or PCR-RFLP. Results The positive rates of K-ras, P53 and P16 gene mutations and combination assay with them in bile supernatant of patients with BTC were 56%, 50%, 33% and 83.3%, respectively. The positive rates of them in duodenal juice were 43%, 36%, 20% and 70%, respectively. However, K-ras gene mutation was detected in only one case with benign choledochlithiasis. Statistic analysis show there was significant difference in those gene mutations between BTC group and benign group (P0.001). Positive rates of K-ras, P53 and P16 gene mutations were higher in the supernatant than that in the sediment (P0.001). For the negative of blie duct brushing in BTC, positive rate of combination assay with these gene mutations was still high (66.67%). Conclusions Combined assay of K-ras, P53 and P16 gene mutations in duodenal juice might be useful for diagnosis of BTC.
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