Development of novel diagnostic system for pancreatic cancer, including early stages, measuring mRNA of whole blood cells

Abstract

Pancreatic ductal adenocarcinoma ( PDAC ) is the most life‐threating disease among all digestive system malignancies. We developed a blood mRNA PDAC screening system using real‐time detection PCR to detect the expression of 56 genes, to discriminate PDAC from noncancer subjects. We undertook a clinical study to assess the performance of the developed system. We collected whole blood RNA from 53 PDAC patients, 102 noncancer subjects, 22 patients with chronic pancreatitis, and 23 patients with intraductal papillary mucinous neoplasms in a per protocol analysis. The sensitivity of the system for PDAC diagnosis was 73.6% (95% confidence interval, 59.7%‐84.7%). The specificity for noncancer volunteers, chronic pancreatitis, and patients with intraductal papillary mucinous neoplasms was 64.7% (54.6%‐73.9%), 63.6% (40.7%‐82.8%), and 47.8% (26.8%‐69.4%), respectively. Importantly, the sensitivity of this system for both stage I and stage II PDAC was 78.6% (57.1%‐100%), suggesting that detection of PDAC by the system is not dependent on the stage of PDAC . These results indicated that the screening system, relying on assessment of changes in mRNA expression in blood cells, is a viable alternative screening strategy for PDAC.

Eight-year longitudinal study of whole blood gene expression profiles in individuals undergoing long-term medical follow-up

“…As we mentioned above, the average age of the participants when the study was initiated was 50 years and the observation period was 8 years. To date, we have reported that gene expression analysis of whole blood cells is beneficial for understanding diseases such as cancer and metabolic syndrome, including diabetes mellitus 4 , 7 , 12 , 32 . From 50 to 60 years of age, various common diseases may develop due to increasing age 33 ; thus, laboratory medicine using gene expression analysis of whole blood cells might have the potential to be a novel avant-garde tool for understanding and obtaining an early diagnosis of diseases.…”

Predictive Values of Blood-Based RNA Signatures for the Gemcitabine Response in Advanced Pancreatic Cancer

“…This study paves the way for the use of blood-based RNA signatures that currently remain uncommon in PDAC. Sakai et al reported a diagnostic test with a similar approach, but this is the first report of a blood-based predictive signature [15]. It will require to be validated on an external cohort and on patients that did not receive gemcitabine to assess whether the GE score only has a predictive value or also carry a prognostic value, potentially broadening its use to select patients fit for surgery for instance.…”

A Blood-based Gene-expression Scoring System for Cancer Screening in Patients With Branch-duct Intraductal Papillary Mucinous Neoplasms

“…Therefore, we decided to use whole blood for a blood-based screening system that might be faster and more concise than other methods. A similar method was previously utilized to develop a blood-based mRNA screening system for pancreatic cancer (27). In this study, the authors compared the gene expression between PDAC and healthy controls and developed a 56-gene diagnostic system.…”