Urine Test Can Be Used In the Early Stage Diagnosis of Pancreatic Cancer
Abstract： A research team from Queen Mary University of London in the UK found a low-cost, non-invasive method which could diagnose the disease in its early stages by using patients’ urine.
Pancreatic cancer is one of the leading cause of cancer related deaths in developed countries. Due to the lack of specific clinical symptoms and accurate body fluid–based biomarkers in the early stage of the disease, insufficient sensitivity of current imaging modalities and difficulties in differentiating cancer from chronic pancreatitis, 80% of patients are diagnosed at later stages, which decreases their likelihood of successful treatment. Recently, a research team from Queen Mary University of London in the UK found a low-cost, non-invasive method which could diagnose the disease in its early stages by using three biomarker panel from patients’ urine.
In this study, proteomes of 18 urine samples derived from pancreatic ductal adenocarcinoma (PDAC), chronic pancreatitis (CP), and healthy individuals (6 per group, three males and three females) were assayed using GeLC/MS/MS analysis. The MS analysis was performed separately on urine samples from male and female subjects since there were considerable gender specific differences. Three proteins ( LYVE-1, REG1A, and TFF1) were selected as candidate biomarkers and were subsequently validated with ELISA assays on 371 urine samples( 87 healthy, 92 CP, and 192 PDAC ). The receiver-operating characteristic curves (ROC) was used to investigate the ability of each individual biomarker and the panel to discriminate patients with PDAC (all stages, or early stages I–II) and control samples (healthy and CP). For each comparison, 70% of the subjects in the patient and control datasets were randomly selected and included in the training dataset and the rest 30% of the subjects were grouped as independent datasets and used for model validation.
Results showed that LYVE-1, REG1A, and TFF1 formed a powerful urinary panel which was able to diagnose stage 1 and 2 pancreatic cancer with more than 90% accuracy. Moreover, in the exploratory analysis, when comparing PDAC stage I–II (n =71) with healthy urine specimens, the AUC increased from 0.97 to 0.99 with plasma CA19.9 added to the panel, but did not improve the comparison of stage I–IIA PDAC (locally invasive disease without lymph node metastases, n=16) with healthy urine. Although large cohort study is required to confirm these findings, this study shows it is possible to detect patients with early-stage pancreatic cancer in urine specimens.
 Tatjana Crnogorac-Jurcevic et al.,2015,Identification of a three-biomarker panel in urine for early detection of pancreatic adenocarcinoma, Clinical Cancer Research, doi: 10.1158/1078-0432.CCR-14-2467.