[摘要] 目的:利用高通量测序平台研究胰腺黏液性囊腺癌（PMCC）组织中基因突变的分布特点及其临床意义。方法: 收集2012 年1 月至2016 年12 月经外科手术切除的4 例PMCC患者癌及癌旁组织石蜡标本,通过Illumina Hiseq 2500 平台进行二代基因测序（NGS），结合患者临床病理资料分析PMCC患者癌组织的基因突变特征。结果: 在4 个PMCC样本中，均检测到7 个高频 突变基因（SMG），分别是KRAS、AHNAK2、MUC16、MUC17、MUC19、MUC3A和MUC4。3 个样本中检测到24 个SMG，分别为ADAMTS9、ALDH3B1、CARD14、CSMD3、MKI67、OR1N2、PKHD1、PLCE1、RTL1、SIGLEC12、CCDC168、CEP295、CUBN、DST、HRNR、LAMA5、OR10G4、OR2T4、PLEKHG4B、RP1L1、SLC15A5、SVEP1、TAS1R1 和TNRC18。所有样本中均检测到KRAS驱动基因突变，其中3 例检测到KRAS 的K12 热点突变，另1 例检测到KRAS 的D33E 非热点突变。结论: PMCC患者的高突变KRAS和MUC家族，可能成为PMCC精准治疗的潜在靶点和生物标志物。

[Abstract] Objective：To detect the distribution of gene mutations in pancreatic mucinous cystadenocarcinoma (PMCC) by highthroughput sequencing and to explore its clinical significance. Methods: Four cases of paraffin-embedded cancer tissues and paracancerous tissues from PMCC patients, who underwent surgical resection from January 2012 to December 2016, received NGS (next generation sequencing) examination using Illumina Hiseq 2500 platform. The characteristics of gene mutation in PMCC patients were analyzed with sequencing results and clinicopathological data. Results: Seven significantly mutated genes (SMGs) were detected in all four PMCC samples, namely KRAS, AHNAK2, MUC16, MUC17, MUC19, MUC3A and MUC4. Twenty-four SMGs were detected in 3 of the 4 samples, namely ADAMTS9, ALDH3B1, CARD14, CSMD3, MKI67, OR1N2, PKHD1, PLCE1, RTL1, SIGLEC12,CCDC168, CEP295, CUBN, DST, HRNR, LAMA5, OR10G4, OR2T4, PLEKHG4B, RP1L1, SLC15A5, SVEP1, TAS1R1 and TNRC18.KRAS-driven gene mutations were detected in all 4 samples, including K12 hot spot mutation in 3 cases and D33E non-hot spot mutation in 1 case. Conclusion: The high mutation of KRAS and MUC family in PMCC may be a potential target and biomarker for precise treatment of PMCC.

国家自然科学基金资助项目（NO.81672892）