Prospective Markers for Early Diagnosis and Prognosis of Sporadic Pancreatic Ductal Adenocarcinoma

• Published in: Digestive diseases and sciences 2013-03, Vol.58 (3), p.744-750
• Main Authors: Tobi, Martin, Kim, Mijin, Weinstein, Douglas H., Rambus, Mary Ann, Hatfield, James, Adsay, N. Volkan, Levi, Edi, Evans, Douglas, Lawson, Michael J., Fligiel, Suzanne
• Format: Article
• Language: English
• Subjects: Adenocarcinoma; Aged; Aged, 80 and over; Biochemistry; Biomarkers, Tumor - blood; Biomarkers, Tumor - chemistry; Biomarkers, Tumor - genetics; Biomarkers, Tumor - metabolism; Body Fluids - chemistry; Cancer; Carcinoma, Pancreatic Ductal - blood; Carcinoma, Pancreatic Ductal - diagnosis; Carcinoma, Pancreatic Ductal - metabolism; Diagnosis; Enzyme-linked immunosorbent assay; Feces - chemistry; Female; Gastroenterology; Gene Expression Regulation, Neoplastic; Genes, ras; Hepatology; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Monoclonal antibodies; Mutation; Oncology; Oncology, Experimental; Original Article; Pancreatic cancer; Pancreatic Neoplasms - blood; Pancreatic Neoplasms - diagnosis; Pancreatic Neoplasms - metabolism; Pneumoviridae; Prognosis; Prospective Studies; Receptor, ErbB-2 - genetics; Receptor, ErbB-2 - metabolism; Retrospective Studies; Transplant Surgery
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-012-2387-x

Background and Aim Sporadic pancreatic ductal adenocarcinoma (PDA) is a highly lethal cancer. No proven screening strategies are available and frequent cross-sectional imaging studies (CT/MRI) are impractical even in patients thought to be at higher risk than the general population. Few PDA biomarkers have been studied prospectively for screening. Here, we prospectively evaluated the Adnab-9 monoclonal antibody in stool, pancreaticobiliary secretions, and tissue for screening and prognostic value in sporadic PDA. We also evaluated the prognostic value of characterized early biomarkers in pancreaticobiliary secretions. Methods Adnab-9 diagnostic ability was tested in stool in 249 and 1,132 patients from China and the US, respectively. Immunohistochemistry was performed in 22 tissue samples with Adnab-9 antibody and anti-Defensin 5, a constituent of Paneth cells. Pancreatobiliary secretions were collected from 12 PDA patients and 9 controls. The enriched PCR method was performed to detect K-ras mutations. ELISA was performed with Adnab-9, anti-Her-2/ neu , and monoclonal antibody D4 (anti-Reg I). Results Adnab-9 alone was diagnostic and prognostic when measured in pancreatic secretions, feces, and tissues of PDA patients compared to controls ( p