Potential Biomarkers To Identify Benign Pancreatic Lesions

Potential Diagnostic Testing

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.

Testing for the Proteins:

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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.

Pancreatic cysts have always worried patients as well as doctors, because of the unknown risk of these lesions developing into cancer. Most patients are subjected to surgery or invasive tests to ensure that these cysts are harmless and that they do not lead to cancer. Dr. C. Max Schmidt, MD, PhD, FACS, who is the study author and a professor of surgery and biochemical/molecular biology at Indiana University School of Medicine said that the test that involves both VEGF-A as well as CEA could be used to identify patients who do have the risk for cancer and hence avoid the need for surgery in them.

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

The samples of the pancreatic cyst fluid were used to detect the levels of VEGF-A and CEA, using enzyme linked biochemical assays.

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 :

1. Treatment & Support - (https://www.cancer.org/treatment.html)
2. 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
3. General Information About Pancreatic Cancer - (https://www.cancer.gov/types/pancreatic/patient/pancreatic-treatment-pdq)

Source: Medindia