Biomarker Panel for the Diagnosis of Pancreatic Ductal Adenocarcinoma

Abstract

A single tumor marker has a low diagnostic value in pancreatic cancer. Combinations of multiple biomarkers and unique analysis algorithms can be applied to overcome these limitations. This study sought to develop diagnostic algorithms using multiple biomarker panels and to validate their performance in the diagnosis of pancreatic ductal adenocarcinoma (PDAC). We used blood samples from 180 PDAC patients and 573 healthy controls. Candidate markers consisted of 11 markers that are commonly expressed in various cancers and which have previously demonstrated increased expression in pancreatic cancer. Samples were divided into training and validation sets. Five linear or non-linear classification methods were used to determine the optimal model. Differences were identified in 10 out of the 11 markers tested. We identified 2047 combinations, all of which were applied to 5 separate algorithms. The new biomarker combination consisted of 6 markers (ApoA1, CA125, CA19-9, CEA, ApoA2, and TTR). The area under the curve, specificity, and sensitivity were 0.992, 95%, and 96%, respectively, in the training set. Meanwhile, the measures were 0.993, 96%, and 93% in the validation set. This study demonstrated the utility of multiple biomarker combinations in the early detection of PDAC. A diagnostic panel of 6 biomarkers was developed and validated. These algorithms will assist in the early diagnosis of PDAC.

Low APOA-1 Expression in Hepatocellular Carcinoma Patients Is Associated With DNA Methylation and Poor Overall Survival

“…Nonetheless, some investigators have increasingly turned their attention to the interaction between serum APOA-1 protein and cancer. Kim et al ( Kim et al, 2020 ) collected blood samples from 180 patients with pancreatic ductal adenocarcinoma (PDAC) and 573 healthy controls to determine whether APOA-1 is a new biomarker for early diagnosis of PDAC. Peng et al ( Peng et al, 2019 ) found that high-grade bladder cancer (BC) patients have significantly higher APOA-1 levels than do low-grade BC patients, indicating that circulating APOA-1 protein may be a novel biomarker for BC diagnosis and prognosis monitoring.…”

Primary pancreatic cystadenocarcinoma with ovarian metastases in a 38-year-old female: case report

“…Some patients also show unresectable or local advanced pancreatic cancer with vascular invasion and distant metastases, sometimes losing the chance for pancreatectomy. Pre-operative serum level of CA125 can increase in ovarian cancers, but it is also elevated in a large portion of pancreatic cancer, which impair the specificity of ovarian cancer diagnosis ( 7 , 8 ). Radiological method such CT and MRI could distinguish the pancreatic cancer and metastatic site efficiently ( 9 , 10 ).…”

The Urokinase Plasminogen Activation System in Pancreatic Cancer: Prospective Diagnostic and Therapeutic Targets

“…This is because ~7% of the population do not express the antigen and the high occurrence of false positives and non-specific expression of CA19-9 compromise the differential diagnosis between malignant adenocarcinomas and benign pancreato-biliary pathologies, including chronic pancreatitis (CP), cholangitis and obstructive jaundice [ 126 , 127 , 128 , 129 ]. As such, CA19-9 is generally supported for the assessment of recurrence or survival after curative resection, rather than an initial or early-stage diagnostic screening [ 130 , 131 , 132 ]. To add to these challenges, the value of using a single tumour biomarker for diagnosing PDAC is limited due to the inherent intra-tumour heterogeneity present in pancreatic tumours, thus, necessitating methods using combinations of multiple biomarkers to overcome these challenges [ 131 ].…”