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Two microRNA diagnostic panels may detect pancreatic cancer
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Two diagnostic panels evaluating microRNA expression in whole blood may be able to identify patients with pancreatic cancer, according to study results.
The analysis included 409 patients with pancreatic cancer who were enrolled in the Danish BIOPAC study from 2008 to 2012. Twenty-five patients with chronic pancreatitis and 312 healthy blood donors were included as controls.
Researchers assigned participants to the discovery cohort (pancreatic cancer, n=143; pancreatitis, n=18; healthy controls, n=69), training cohort (pancreatic cancer, n=180; pancreatitis, n=1; healthy controls, n=199) or validation cohort (pancreatic cancer, n=86; pancreatitis, n=7; healthy controls, n=44).
Among 754 microRNAs screened in the discovery cohort, researchers observed 38 that were significantly dysregulated in patients with pancreatic cancer compared with controls.
Based on results from the training cohort, researchers developed two diagnostic panels consisting of 14 microRNAs.
Index I included miR-145, miR-150, miR-223 and miR-636. Index II included miR-26b, miR-34a, miR-122, miR-126*, miR-145, miR-150, miR-223, miR-505, miR-636 and miR-885.5p.
Researchers also evaluated serum cancer antigen 19-9 (CA19-9) for comparison.
Evaluating data from patients in the training cohort with pancreatic cancer compared with controls, researchers calculated an area under the curve (AUC) of 0.86 (95% CI, 0.82-0.9) for index I, 0.93 (95% CI, 0.9-0.96) for index II and 0.9 (95% CI, 0.87-0.94) for CA19-9.
The accuracy of the diagnostic panels improved in the validation cohort when they were combined with CA19-9 (index I, AUC=0.94; 95% CI, 0.9-0.98; index II, AUC=0.93; 95% CI, 0.89-0.97).
Among patients with pancreatic cancer in the validation cohort, 85% received a correct diagnosis with index I or II, with or without serum CA19-9.
“Although there is a risk of generating false-positive test results using our panels of microRNAs in combination with serum CA19-9, the test could refer more individuals with characteristic or uncharacteristic symptoms to CT, magnetic resonance or ultrasound imaging,” the researchers wrote. “The test could thereby diagnose more patients with pancreatic cancer, some of them at an early stage, and thus have a potential to increase the number of patients that can be operated on and possibly cured of pancreatic cancer.”
Carlo M. Croce
More analysis is necessary to confirm the diagnostic value of microRNA in pancreatic cancer, Donald J. Buchsbaum, PhD, of the department of radiation oncology at the University of Alabama in Birmingham, and Carlo M. Croce, MD, of the department of molecular virology, immunology and medical genetics at Ohio State University, wrote in an invited commentary.
“Despite the modest improvements in AUC, the data reported in the study by Shultz et al did not demonstrate that the microRNA signatures provided clinically significant information over serum CA19-9,” Buchsbaum and Croce wrote. “Further research is necessary to understand whether microRNA signatures have clinical implications for the early detection of pancreatic cancer and whether this information adds substantially to serum CA19-9.”
Disclosure: Researchers report affiliation with patents licensed to Copenhagen University Hospital.
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