许多作者报告多中心性胰腺癌的发生率为15～40%,故是否行全胰切除成为争论焦点。有人报告胰腺癌的复发更常见于胰床和胰肠吻合口周围组织,而不在胰残端、由此可见胰腺癌的多中心性并无很重要意义,对其发生率也仍有争论。通过对ras基因家族中导致癌基因激活的点突变研究,发现在多种人体肿瘤有12、13和61密码子的点突变,其中以胰腺癌中Ki-ras点突变发生率最高,约90%病人至少有一种突变。聚合酶链反应(PCR)做为一种克隆标记物已用于突变检测。为进一步评价有关多中心性胰腺癌的争论问题,作者用PCR方法对1975～1990年间治疗的53例胰腺肿瘤进行了Ki-ras突变检测,并假设多中心性胰腺癌来自多发性Ki-ras突变。53例病人均经病理组织学证实为胰腺癌,其中45例肿瘤已切除,8例 Many authors report that the incidence of multicentric pancreatic cancer is 15-40%, so whether to perform pancreatectomy is the focus of controversy. It has been reported that the recurrence of pancreatic cancer is more common in the tissues around the anastomosis of the pancreas and pancreas, but not in the pancreatic stump, and thus the multicentricity of pancreatic cancer is not of great significance. The incidence of pancreatic cancer is still controversial. Through point mutations that cause oncogene activation in the ras gene family, point mutations at 12, 13, and 61 codons have been found in a variety of human tumors, of which the highest incidence of Ki-ras point mutations in pancreatic cancer is about 90%. The patient has at least one mutation. Polymerase chain reaction (PCR) has been used as a cloning marker for mutation detection. To further evaluate the controversy over multicentric pancreatic cancer, the authors performed a Ki-ras mutation test using PCR on 53 cases of pancreatic tumors treated between 1975 and 1990, and hypothesized that multi-center pancreatic cancer results from multiple Ki-ras mutations. . All 53 patients were confirmed by histopathology as pancreatic cancer, of which 45 had been resected and 8 had