“For the first time, we have found a very strong candidate molecular marker.”
Clinical researchers have found a promising method for distinguishing pancreatic cancer from chronic pancreatitis, or inflammation of the pancreas, at an early stage when intervention can be critical.
Pancreatic cancer and pancreatitis produce similar symptoms. But distinguishing between the two diseases is a matter of life and death. Pancreatic cancer is usually fatal, but chronic pancreatitis can be treated with diet, enzyme supplements, and surgery.
“Many researchers have been working on such a diagnostic test for a long time—for me, it has been 20 years,” says lead investigator Massimo Raimondo, a gastroenterologist at Mayo Clinic in Florida. “But for the first time, we have found a very strong candidate molecular marker.”
The research team examined secretions from the pancreas during routine upper endoscopy, a procedure using a thin flexible scope to examine the upper digestive tract. They injected the hormone secretin through an intravenous line inserted into patients undergoing the procedure when chronic pancreatitis or pancreatic cancer was suspected, to increase secretions from the pancreas. Enough exfoliated cells from the pancreas were present in the collected fluid that researchers could test the cells for biomarkers of pancreatic disease.
One gene, CD1D, popped up as a single marker for cancer. A mutation in the gene was predictive and present in 75 percent of patients later diagnosed with pancreatic cancer, but only in nine percent of patients with chronic pancreatitis.
“CD1D performed much better than any other pancreatic secretion marker previously tested in identifying pancreatic cancer,” says Raimondo.
A non-surgical method for early detection of pancreatic cancer that could be performed on a somewhat routine basis in patients at risk of developing the disease could dramatically improve prognosis. Smoking significantly increases the chances of developing pancreatic cancer, as do diabetes and pancreatitis. Other risk factors include obesity and a family history of the cancer.
The results “have clear practice-changing implications,” says co-author David Ahlquist, who led a group of collaborators on the study at Mayo Clinic in Rochester.
The early stages of pancreatic cancer do not usually produce symptoms, precluding early diagnosis. It has a poor prognosis even when it is diagnosed early, since it spreads rapidly, invading nearby tissues. The cancer is almost always fatal, and is the eighth most common cause of death from cancer. Less than four percent of people with pancreatic cancer are alive at five years after diagnosis.
In 2008, pancreatic cancer was the thirteenth most common cancer in the world, with 280,000 new cases diagnosed that year alone. The disease is more frequent in high-income countries where rates are increasing. In the U.S. there are close to 38,000 cases of pancreatic cancer each year.
“While we know more research is needed, including validation of our findings, we can't help but be excited about this advance,” says Raimondo.
May 31, 2013
http://www.burrillreport.com/article-biomarker_for_pancreatic_cancer_identified.html