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

Abstract

<jats:p>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 &lt; 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.</jats:p>

Spatial drivers and pre-cancer populations collaborate with the microenvironment in untreated and chemo-resistant pancreatic cancer

“…In acinar cells, we detected high expression of regenerating family member genes, such as REG1B and REG3A in the naïve group only. Higher expression of amylases and lipase genes were found in both treated groups, which have been previously associated with chronic pancreatitis and pancreatic cancer ( Figure S7A ) (Raphael et al, 2016; Stotz et al, 2020; Lasher et al, 2019). In endothelial cells, we observed an upregulation in metallothioneins in treated samples, particularly in gemcitabine+nab-paclitaxel samples.…”

Determination of Activation Energies and the Optimum Temperatures of Hydrolysis of Starch by α-Amylase from Porcine Pancreas

“…3.2.1.1) catalyze the hydrolysis of α -1,4 glycosidic bonds present in starch, glycogen and other related carbohydrates to low molecular weight products, such as glucose, maltose and maltotriose [ 4 , 5 , 6 , 7 , 8 ]. These enzymes are present in plants, animals and microorganisms [ 9 ] and have extensive applications in medicine [ 10 , 11 , 12 , 13 , 14 ], textiles [ 11 ], detergent [ 11 ], fermentation [ 11 ] and the food industry [ 4 , 11 ].…”

“…In addition to industrial use, α -amylase from porcine pancreas is used for example in health food research [ 16 , 17 , 18 ], to assay resistant starch (RS), not broken down by human enzymes in the small intestine [ 19 ] and is also used in medical diagnostics [ 12 , 13 , 14 ]. One of the problems is effective diagnostic methods allowing for the prognosis of pancreatic cancer of cancer, which is an exceptionally aggressive tumour with high mortality.…”

“…One of the problems is effective diagnostic methods allowing for the prognosis of pancreatic cancer of cancer, which is an exceptionally aggressive tumour with high mortality. Stotz et al [ 12 ] hypothesized that the level of α -amylase and lipase quantities in the peripheral blood and the calculation of the lipase and α -amylase ratio at the time of localized pancreatic cancer might represent a novel marker for individualized patient risk assessment pancreatic cancer.…”

Real‐world prognostic factors for survival among treated patients with metastatic pancreatic ductal adenocarcinoma

“…Real-world studies reported in the literature have included estimates of the prognostic impact of patient and disease characteristics in patients receiving systemic therapy for mPDAC. [17][18][19][20][21] Such studies have been limited in sample size due to a reliance on one or a limited number of study centers or a focus on patients receiving a particular drug regimen. This has limited their usefulness for guiding decision-making in the treatment of patients with mPDAC.…”