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CA19-9 and apolipoprotein-A2 isoforms as detection markers for pancreatic cancer: a prospective evaluation.
- Source :
-
International journal of cancer [Int J Cancer] 2019 Apr 15; Vol. 144 (8), pp. 1877-1887. Date of Electronic Publication: 2018 Dec 04. - Publication Year :
- 2019
-
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.<br /> (© 2018 UICC.)
- Subjects :
- Adult
Aged
Case-Control Studies
Enzyme-Linked Immunosorbent Assay
Female
Humans
Male
Middle Aged
Pancreas diagnostic imaging
Pancreas pathology
Pancreatic Neoplasms blood
Pancreatic Neoplasms pathology
Predictive Value of Tests
Prospective Studies
Protein Isoforms analysis
Protein Isoforms metabolism
ROC Curve
Time Factors
Apolipoprotein A-II blood
CA-19-9 Antigen blood
Early Detection of Cancer methods
Pancreatic Neoplasms diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1097-0215
- Volume :
- 144
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- International journal of cancer
- Publication Type :
- Academic Journal
- Accession number :
- 30259989
- Full Text :
- https://doi.org/10.1002/ijc.31900