Elevated amylase in plasma represents an adverse prognostic marker in patients with metastatic pancreatic cancer

Asamer, Eva; Szkandera, Joanna; Gibiser, Paul; Lembeck, Anna L; Stojaković, Tatjana; Kornprat, Peter; Lackner, C.; Winder, Thomas; Schlick, Konstantin; Stöger, Herbert; Gerger, Armin; Pichler, Martin; Stotz, Michael

doi:10.1007/s00508-018-1383-3

Cited by 4 publications

(6 citation statements)

References 20 publications

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“…Univariate Cox proportional analysis shows no significant difference for survival for the LAR (HR: 1.12, 95% CI: 0.87–1.43, p = 0.363), whereas—as previously reported [ 26 ]—for amylase (HR: 1.26, 95% CI: 10.01–1.57, p = 0.039) and lipase (HR: 1.25, 95% CI: 1.01–1.56, p = 0.039) a significant association with survival could be observed.…”

Section: Resultssupporting

confidence: 75%

“…In the present study, we examined a large cohort of patients with surgically resected pancreatic cancer and found a statistically significant association between the preoperative LAR in the peripheral blood and the patients’ survival. In a recently published study, our group reported the value of amylase levels as an adverse factor in metastatic pancreatic cancer [ 26 ]. In this cohort of localized pancreatic cancer patients, we could not find an association between amylase or lipase levels and survival.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, biochemical biomarkers, e.g., uric acid, were demonstrated to contain potentially important prognostic information in pancreatic cancer [ 21 , 22 ]. Both amylase and lipase have recently been investigated regarding their potential prognostic value in pancreatitis and pancreatic cancer, as well as in intraductal papillary mucinous neoplasm (IPMN) [ 23 , 24 , 25 , 26 ]. The lipase/amylase ratio (LAR) has been proposed as a possible new index that is able to distinguish acute episodes of alcoholic from non-alcoholic acute pancreatitis [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

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The Lipase/Amylase Ratio (LAR) in Peripheral Blood Might Represent a Novel Prognostic Marker in Patients with Surgically Resectable Pancreatic Cancer

Stotz

Barth

Riedl

et al. 2020

Cancers

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Pancreatic enzymes might play a pivotal role in the pathophysiology and prognosis of pancreatic cancer. The aim of this study is to investigate the lipase/amylase ratio (LAR), representing a marker previously used in the differentiation of pancreatitis, as a potential prognostic marker in pancreatic cancer. Data from 157 surgically treated patients with ductal pancreatic adenocarcinoma and 351 patients with metastatic disease were evaluated retrospectively. Cancer-specific survival (CSS) was considered the endpoint of the study. After applying Kaplan–Meier curve analysis, uni- and multivariate Cox regression models were calculated to evaluate the prognostic relevance of LAR. An elevated LAR at diagnosis of localized pancreatic cancer was significantly associated with higher CA19-9 levels (p < 0.05). In univariate analysis, we observed an increased LAR as a significant factor for lower CSS in localized pancreatic cancer patients (HR = 1.63; 95% CI = 1.12–2.36; p = 0.01), but not in metastatic patients (HR = 1.12; 95% CI = 0.87–1.43; p = 0.363). In multivariate analysis, including age, gender, tumor stage, Karnofsky Performance Status, tumor grade, administration of chemotherapy and the LAR, an increased LAR was confirmed to represent an independent prognostic factor regarding CSS (HR = 1.81; 95% CI = 1.17–2.77; p = 0.007) in localized pancreatic cancer patients. In conclusion, our study identified the LAR as an independent prognostic factor in surgically treated pancreatic cancer patients.

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Section: Resultssupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Lipase/Amylase Ratio (LAR) in Peripheral Blood Might Represent a Novel Prognostic Marker in Patients with Surgically Resectable Pancreatic Cancer

Stotz

Barth

Riedl

et al. 2020

Cancers

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“…In present study, after excluding patients with AP, the incidence of hyperenzymemia was 25.2% (35/139), and we first found that hyperenzymemia was associated with a decreased RFS of patients with NF‐PNENTs. Similarly, Asamer et al 37 showed that an increased amylase level was associated with shorter cancer‐specific survival of patients with metastatic pancreatic cancer. Recently, their team also found that the lipase/amylase ratio was an independent prognostic factor for pancreatic cancer patients 15 .…”

Section: Discussionmentioning

confidence: 89%

Preoperative acute pancreatitis and hyperenzymemia are associated with poor prognosis in patients with nonfunctional pancreatic neuroendocrine tumors

Song

Tan

Yuan

et al. 2023

Journal of Surgical Oncology

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Background We aimed to investigate the prevalence of acute pancreatitis (AP) and hyperenzymemia as well as their clinical impact on postoperative survival outcomes in patients with pancreatic neuroendocrine tumors (PNETs). Methods A retrospective cohort study of 218 patients who underwent radical surgical resection for nonfunctional PNETs (NF‐PNETs) was conducted. Multivariate survival analysis was performed by the Cox proportional hazard model, with results expressed as hazard ratio (HR) and 95% confidence interval (CI). Results Of the 151 patients who met the inclusion criteria, the incidences of preoperative AP and hyperenzymemia were 7.9% (12/152) and 23.2% (35/151), respectively. The mean recurrence‐free survival (RFS, 95% CI) for patients in control, AP, and hyperenzymemia groups was 136 (127–144), 88 (74–103), and 90 (61–122) months, with a 5‐year RFS rate of 86.5%, 58.3%, and 68.9%, respectively. In the multivariable‐adjusted Cox hazard model that included tumor grade and lymph node status, the adjusted HR of AP and hyperenzymemia for recurrence was 2.58 (95% CI: 1.47–7.86, p = 0.008) and 2.43 (95% CI: 1.08–7.06, p = 0.040). Conclusion Preoperative AP and hyperenzymemia are associated with poor RFS following radical surgical resection in NF‐PNETs patients.

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“…Therefore, both pancreatic inflammation and leakage or damage of gut epithelium integrity can cause an increase in serum amylase[ 30 , 31 ]. Previous analysis of 351 metastatic PC patients showed that there was a positive association between the increased plasma amylase level and negative prognostic outcomes for PC[ 32 ]. Thus, the observation of elevated serum amylase levels from the COVID-19 patients highlights the importance to investigate the crosstalk between the SARS-CoV-2 infection, the pancreatic-associated inflammation, and the gut-associated inflammation.…”

Section: Pancreatic Injury and Abnormalities In Covid-19 Patientsmentioning

confidence: 99%

Crosstalk between gut microbiota and COVID-19 impacts pancreatic cancer progression

Zhang¹,

Liu²,

Yang³

2022

WJGO

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Pancreatic cancer (PC) is one of the most common causes of cancer-associated death worldwide, with a low rate of 5-year survival. Currently, the pathogenesis of PC is complicated, with no efficient therapy. Coronavirus disease 2019 (COVID-19) disease caused by severe acute respiratory syndrome coronavirus 2 further exacerbates the challenge of patients with PC. The alteration of gut microbiota caused by COVID-19 infection may impact PC progression in patients via immune regulation. The expression of inflammatory immune mediators such as interleukin (IL)-6, IL-8, and IL-10 has been found to increase in both PC and COVID-19 patients, which is associated with the disease severity and prognostic outcome. Gut microbiome serves as a critical connector between viral infection and PC. It can regulate host systemic immune response and impact the efficacy of immunotherapy. Here, we first demonstrated the features of inflammatory cytokines in both diseases and their impact on disease outcomes. Then, we demonstrated the importance of immunotherapeutic strategies. This includes the immune modulation that targets a single or dual receptors using a single agent or their combinations for the treatment of PC in patients who get infected with COVID-19. Additionally, we explored the possibility of managing the disease by regulating gut microbiome. Overall, modulation of the lung-gut-pancreases axis can boost anti-cancer immunotherapy and reduce adverse prognostic outcomes.

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Elevated amylase in plasma represents an adverse prognostic marker in patients with metastatic pancreatic cancer

Cited by 4 publications

References 20 publications

The Lipase/Amylase Ratio (LAR) in Peripheral Blood Might Represent a Novel Prognostic Marker in Patients with Surgically Resectable Pancreatic Cancer

The Lipase/Amylase Ratio (LAR) in Peripheral Blood Might Represent a Novel Prognostic Marker in Patients with Surgically Resectable Pancreatic Cancer

Preoperative acute pancreatitis and hyperenzymemia are associated with poor prognosis in patients with nonfunctional pancreatic neuroendocrine tumors

Crosstalk between gut microbiota and COVID-19 impacts pancreatic cancer progression

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