- It is difficult to distinguish between cancerous and non-cancerous variants of pancreatic cysts
- Two tests that assess the level of proteins VEGF-A and CEA have been found to be good indicators of cysts that are not cancerous
- These tests are potential biomarkers and can be used to limit the need for invasive diagnostic procedures
Pancreatic cancer is a cancer of the
pancreas that is difficult to detect early.
Pancreatic lesions or cysts develop within the pancreas, and while some cysts
are non-inflammatory, others are inflammatory in nature. These cysts range in
size from millimeters to several centimeters; some cysts may be small and
benign without resulting in any symptom. However, some cysts are cancerous.
It
has been difficult to distinguish between lesions that are cancerous and those
that are benign, without invasive testing procedures. However, a recent study
by a research team from Indiana University has found that when two laboratory
tests are performed in tandem, pancreatic lesions that are benign, but which
closely resemble pre-cancerous lesions, may be identified.
The study was published in the journal of the American College of Surgeons, and it is one of the largest studies conducted on pancreatic lesions.
- 2-3% of patients get detected with pancreatic lesions on a routine abdominal scan.
- The 5 year survival rate of these patients is
- 12-14% for those with early stage disease
- 1-3% for those with advanced stage of disease
- A small percentage of these patients detected with pancreatic lesion would have serious cystic neoplasms (SCN). These are non-malignant and do not develop into cancer.
The study by the research team from Indiana University has found that two proteins play an important role in determining if the lesions are pre-cancerous or cancerous.
- Vascular endothelial growth factor A (VEGF-A) is a protein that is found to be involved in the formation of new blood vessels. This protein's expression is increased in many different types of tumors and the research team from Indiana University has used this protein in its diagnostic test.
- Carcinoembryonic antigen (CEA) is a protein that is found to be involved in cell adhesion. This protein, while being present in low levels in healthy individuals, is found in increased levels in individuals with certain types of cancer.
The level of these proteins is tested in pancreatic cyst fluid and the results of the findings are:
- Accurate identification of serious cystic neoplasm (SCN) from other types of pancreatic lesions.
- The levels of VEGF-A independently identified serious cystic neoplasms with a specificity of 83.7% and a sensitivity of 100%.
- The levels of CEA independently identified serious cystic neoplasms with a specificity of 81.5% and a sensitivity of 95.5 %.
- When the tests for the proteins were taken together, they reached the gold standard of pathologic testing. The combined specificity was 100% while sensitivity was 95.5%.
- In the study, the research team found that 26 patients could have been prevented from opting for surgery.
Developing a Diagnostic Technique:
149 study participants who had previously undergone a surgery to remove a pancreatic cyst were included in the study.
- Out of these, 26 participants had serious cystic neoplasm
- Pathological examinations were used to confirm the diagnosis
Further research studies are required to confirm the accuracy of the VEGF-A and CEA levels and the risk of developing pancreatic cancer.
The research team stated that there was a need to carry out the test under stringent conditions, and specimens could be sent to Indiana University Health Pancreatic Cyst and Cancer Early Detection Center for analysis, if required.
There are many ongoing research studies being carried out to identify biological markers for pancreatic cancer. The current study focuses on differentiating between cysts that will not develop into cancer and cysts that would. This will help in reducing the number of people who would require invasive surgical procedures.
References :
- Treatment & Support - (https://www.cancer.org/treatment.html)
- Rosalie A. Carr, Michele T. Yip-Schneider, Scott Dolejs, Bradley A. Hancock, Huangbing Wu, Milan Radovich, C. Max Schmidt. Pancreatic Cyst Fluid Vascular Endothelial Growth Factor A and Carcinoembryonic Antigen: A Highly Accurate Test for the Diagnosis of Serous Cystic Neoplasm. Journal of the American College of Surgeons, 2017; 225 (1): 93 DOI: 10.1016/j.jamcollsurg.2017.05.003
- General Information About Pancreatic Cancer - (https://www.cancer.gov/types/pancreatic/patient/pancreatic-treatment-pdq)
Citations
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APA
Amrita Surendranath. (2017, June 27). Potential Biomarkers To Identify Benign Pancreatic Lesions. Medindia. Retrieved on Aug 07, 2022 from https://www.medindia.net/news/healthinfocus/potential-biomarkers-to-identify-benign-pancreatic-lesions-171207-1.htm.
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MLA
Amrita Surendranath. "Potential Biomarkers To Identify Benign Pancreatic Lesions". Medindia. Aug 07, 2022. <https://www.medindia.net/news/healthinfocus/potential-biomarkers-to-identify-benign-pancreatic-lesions-171207-1.htm>.
Chicago
Amrita Surendranath. "Potential Biomarkers To Identify Benign Pancreatic Lesions". Medindia. https://www.medindia.net/news/healthinfocus/potential-biomarkers-to-identify-benign-pancreatic-lesions-171207-1.htm. (accessed Aug 07, 2022).
Harvard
Amrita Surendranath. 2021. Potential Biomarkers To Identify Benign Pancreatic Lesions. Medindia, viewed Aug 07, 2022, https://www.medindia.net/news/healthinfocus/potential-biomarkers-to-identify-benign-pancreatic-lesions-171207-1.htm.