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 22 February 2018

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News

Improving the diagnosis of pancreatic cancer

The most recent issue of the American Journal of Gastroenterology reports that a combination of MUC5AC and CA19-9 improves the diagnosis of pancreatic cancer.

News image

Pancreatic cancer is a lethal malignancy that lacks specific diagnostic markers. 

Dr Randall Brand and colleagues from Nebraska, USA explores the diagnostic potential of the most differentially overexpressed secretory mucin MUC5AC alone, and in combination with CA19-9 using multi-center training and validation sets.

The expression of MUC5AC in benign pancreatic pathologies, pancreatic cancer precursor lesions, primary pancreatic cancer tissues and metastatic lesions was evaluated by immunohistochemistry. 

Circulating MUC5AC levels were measured using sandwich ELISA assay developed in-house, and CA19-9 was measured using radioimmunoassay. 

The research team used a combined training set to evaluate the diagnostic, and predictive significance of MUC5AC. 

MUC5AC efficiently differentiated early-stage pancreatic cancer from healthy controls
American Journal of Gastroenterology
Results were further validated with a pre-defined cut-off value using independent sets from the Mayo Clinic, and the University of Pittsburgh Medical Center.

The team noted that tissue expression analyses indicated the de novo expression of MUC5AC in pancreatic intraepithelial precursor lesions 1A (PanIN1A).

The expression was maintained through all stages of progression to invasive adenocarcinoma. 

The researchers found that median circulating MUC5AC levels in patients with resectable early-stage pancreatic cancer, and unresectable late-stage pancreatic cancer were significantly higher compared with benign controls, and chronic pancreatitis controls.

In the diagnostic training set, the team found that MUC5AC efficiently differentiated early-stage pancreatic cancer from healthy controls, benign controls, and chronic pancreatitis. 

Independent validation sets from the Mayo Clinic and UPMC confirmed the diagnostic potential of MUC5AC to differentiate early-stage pancreatic cancer from benign controls, and chronic pancreatitis.

Furthermore, the researchers noted that MUC5AC and CA19-9 combination significantly improved the diagnostic accuracy for differentiating resectable cases from controls.

Dr Brand's team comments, "MUC5AC is a valuable diagnostic biomarker, either alone or in combination with CA19-9, to differentiate pancreatic cancer from chronic pancreatitis and benign controls."

Am J Gastroenterol 2017; 112:172–183
23 January 2017

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