To improve the prognosis of patients with pancreatic cancer, a more accurate serum diagnostic method is required. Now researchers have developed a new diagnostic test that uses a scientific technique known as metabolomic analysis that may be a safe and easy screening method.The researchers believe that this new test may improve the prognosis, offering patients with pancreatic cancer a real survival advantage through earlier detection.

According to data from the American Cancer Society, for all stages of pancreatic cancer combined, the one-year relative survival rate is 20%. However, the five-year relative survival rate is less than 5%. These low survival rates are largely attributable to the fact that fewer than 20% of cases the tumor is confined to the pancreas at the time of diagnosis. In most cases, the malignancy has already progressed to the point where surgical removal is impossible. Hence, early detection is crucial.

New diagnostic method
As part of the test, researchers examined the utility of metabolomic analysis as a diagnostic method for pancreatic cancer and then validated the new approach, according to study results published in the OnlineFirst (March 29, 2013) edition of Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.

?Although surgical resection can be a curative treatment for pancreatic cancer, more than 80% of patients with pancreatic cancer have a locally advanced or metastatic tumor that is unresectable at the time of detection,? explained Masaru Yoshida, M.D., Ph.D., associate professor and chief of the Division of Metabolomics Research at Kobe University Graduate School of Medicine in Kobe, Japan. ?Conventional examinations using blood, imaging and endoscopy are not appropriate for pancreatic cancer screening and early detection, so a novel screening and diagnostic method for pancreatic cancer is urgently required.?

Metabolites in Blood
Using gas chromatography mass spectrometry, the researchers measured the levels of metabolites in the blood of patients with pancreatic cancer, patients with chronic pancreatitis and healthy volunteers. They randomly assigned 43 patients with pancreatic cancer and 42 healthy volunteers to a training set and 42 patients with pancreatic cancer and 41 healthy volunteers to a validation set. They included all 23 patients with chronic pancreatitis in the validation set.

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Analysis of the metabolomic data generated from the training set indicated that levels of 18 metabolites were significantly different in the blood of patients with pancreatic cancer compared with the healthy volunteers. Further investigation led the researchers to develop a method to predict a pancreatic cancer diagnosis using assessment of the levels of just four metabolites. In the training set, the approach demonstrated 86% sensitivity and 88.1% specificity. When tested again in the validation set, which included patients with chronic pancreatitis, the method demonstrated 71.4% sensitivity and 78.1% specificity.

Higher accuracy
?Our diagnostic approach using serum metabolomics possessed higher accuracy than conventional tumor markers, especially at detecting the patients with pancreatic cancer in the cohort that included the patients with chronic pancreatitis,? Yoshida said. ?This novel diagnostic approach, which is safe and easy to apply as a screening method, is expected to improve the prognosis of patients with pancreatic cancer by detecting their cancers early, when still in a resectable and curable state.?

For more information:
Kobayashi T, Nishiumi S, Ikeda A, Yoshie T, Sakai A, Matsubara A, Izumi Y, Tsumura H, et al. A Novel Serum Metabolomics-Based Diagnostic Approach to Pancreatic Cancer. Cancer Epidemiology, Biomarkers & Prevention, OnlineFirst March 29, 2013; doi: 10.1158/1055-9965.EPI-12-1033

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