CA19-9 and apolipoprotein-A2 isoforms as detection markers for pancreatic cancer: a prospective evaluation

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Abstract

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.

Detaljer

Författare
  • Kazufumi Honda
  • Verena A. Katzke
  • Anika Hüsing
  • Shinobu Okaya
  • Hirokazu Shoji
  • Kaoru Onidani
  • Anja Olsen
  • Anne Tjønneland
  • Kim Overvad
  • Elisabete Weiderpass
  • Paolo Vineis
  • David Muller
  • Kostas Tsilidis
  • Domenico Palli
  • Valeria Pala
  • Rosario Tumino
  • Alessio Naccarati
  • Salvatore Panico
  • Krasimira Aleksandrova
  • Heiner Boeing
  • H. Bas Bueno-de-Mesquita
  • Petra H. Peeters
  • Antonia Trichopoulou
  • Pagona Lagiou
  • Kay Tee Khaw
  • Nick Wareham
  • Ruth C. Travis
  • Susana Merino
  • Eric J. Duell
  • Miguel Rodríguez-Barranco
  • María Dolores Chirlaque
  • Aurelio Barricarte
  • Vinciane Rebours
  • Marie Chiristine Boutron-Ruault
  • Francesca Romana Mancini
  • Paul Brennan
  • Ghislaine Scelo
  • Malin Sund
  • Daniel Öhlund
  • Federico Canzian
  • Rudolf Kaaks
Enheter & grupper
Externa organisationer
  • National Cancer Center Research Institute, Japan
  • Japan Science and Technology Agency (JST)
  • German Cancer Research Centre
  • National Cancer Center Hospital, Japan
  • Danish Cancer Society Research Center
  • Aarhus University
  • UiT The Arctic University of Norway, Tromsø
  • Cancer Registry of Norway Institute of Population-Based Cancer Research
  • Karolinska Institute
  • Folkhälsans forskningscentrum
  • Imperial College London
  • University of Ioannina
  • Cancer Research and Prevention Institute
  • Istituto Nazionale dei Tumori
  • Civic and M.P.Arezzo Hospital
  • Italian Institute for Genomic Medicine (IIGM)
  • University of Naples Federico II
  • German Institute of Human Nutrition
  • University Medical Center Utrecht
  • National and Kapodistrian University of Athens
  • Harvard University
  • University of Cambridge
  • University of Oxford
  • Public Health Directorate
  • Catalan Institute of Oncology
  • University of Granada
  • CIBER Epidemiology and Public Health (CIBERESP)
  • Murcia Regional Health Council
  • Health Research Institute of Navarra (IDISNA)
  • Beaujon Hospital
  • Paris Diderot University
  • University of Paris-Sud
  • Stabilite genetique et oncogenese
  • International Agency for Research on Cancer, World Health Organization
  • Skåne University Hospital
  • Umeå University
Forskningsområden

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Cancer och onkologi

Nyckelord

Originalspråkengelska
Sidor (från-till)1877-1887
TidskriftInternational Journal of Cancer
Volym144
Utgåva nummer8
StatusPublished - 2019
PublikationskategoriForskning
Peer review utfördJa