Περίληψη:
Recently, we identified unique processing patterns of apolipoprotein A2 (ApoA2) in patients with pancreatic cancer. Our study provides a first prospective evaluation of an ApoA2 isoform (“ApoA2-ATQ/AT”), alone and in combination with carbohydrate antigen 19–9 (CA19-9), as an early detection biomarker for pancreatic cancer. We performed ELISA measurements of CA19-9 and ApoA2-ATQ/AT in 156 patients with pancreatic cancer and 217 matched controls within the European EPIC cohort, using plasma samples collected up to 60 months prior to diagnosis. The detection discrimination statistics were calculated for risk scores by strata of lag-time. For CA19-9, in univariate marker analyses, C-statistics to distinguish future pancreatic cancer patients from cancer-free individuals were 0.80 for plasma taken ≤6 months before diagnosis, and 0.71 for >6–18 months; for ApoA2-ATQ/AT, C-statistics were 0.62, and 0.65, respectively. Joint models based on ApoA2-ATQ/AT plus CA19-9 significantly improved discrimination within >6–18 months (C = 0.74 vs. 0.71 for CA19-9 alone, p = 0.022) and ≤ 18 months (C = 0.75 vs. 0.74, p = 0.022). At 98% specificity, and for lag times of ≤6, >6–18 or ≤ 18 months, sensitivities were 57%, 36% and 43% for CA19-9 combined with ApoA2-ATQ/AT, respectively, vs. 50%, 29% and 36% for CA19-9 alone. Compared to CA19-9 alone, the combination of CA19-9 and ApoA2-ATQ/AT may improve detection of pancreatic cancer up to 18 months prior to diagnosis under usual care, and may provide a useful first measure for pancreatic cancer detection prior to imaging. © 2018 UICC
Συγγραφείς:
Honda, K.
Katzke, V.A.
Hüsing, A.
Okaya, S.
Shoji, H.
Onidani, K.
Olsen, A.
Tjønneland, A.
Overvad, K.
Weiderpass, E.
Vineis, P.
Muller, D.
Tsilidis, K.
Palli, D.
Pala, V.
Tumino, R.
Naccarati, A.
Panico, S.
Aleksandrova, K.
Boeing, H.
Bueno-de-Mesquita, H.B.
Peeters, P.H.
Trichopoulou, A.
Lagiou, P.
Khaw, K.-T.
Wareham, N.
Travis, R.C.
Merino, S.
Duell, E.J.
Rodríguez-Barranco, M.
Chirlaque, M.D.
Barricarte, A.
Rebours, V.
Boutron-Ruault, M.-C.
Romana Mancini, F.
Brennan, P.
Scelo, G.
Manjer, J.
Sund, M.
Öhlund, D.
Canzian, F.
Kaaks, R.
Λέξεις-κλειδιά:
apolipoprotein A2; biological marker; CA 19-9 antigen; APOA2 protein, human; apolipoprotein A2; CA 19-9 antigen; isoprotein, adult; aged; Article; blood sampling; cancer diagnosis; case control study; controlled study; disease duration; early diagnosis; enzyme linked immunosorbent assay; female; human; limit of detection; major clinical study; male; pancreas cancer; priority journal; prospective study; protein analysis; protein blood level; sensitivity and specificity; blood; diagnostic imaging; early cancer diagnosis; evaluation study; metabolism; middle aged; pancreas; pancreas tumor; pathology; predictive value; procedures; receiver operating characteristic; time factor, Adult; Aged; Apolipoprotein A-II; CA-19-9 Antigen; Case-Control Studies; Early Detection of Cancer; Enzyme-Linked Immunosorbent Assay; Female; Humans; Male; Middle Aged; Pancreas; Pancreatic Neoplasms; Predictive Value of Tests; Prospective Studies; Protein Isoforms; ROC Curve; Time Factors
