Screening for Pancreatic Cancer One Molecule at a Time

Pancreatic cancer metabolomic test shows high accuracy

(RxWiki News) Right now, there’s no easy way to find pancreatic cancer in its early stages. A new test being studied may change that and the way this disease is treated.

Scientists have developed a way to screen for a set of 18 compounds that are seen more often in people with pancreatic cancer than in healthy people.

Once perfected, this test may change the course – and curse – of pancreatic cancer.

"See a doctor if burning in your stomach doesn't go away."

Pancreatic cancer is discovered in just over 45,000 Americans every year. Because it's so often detected after the disease is well-established, patients with pancreatic cancer don't have very good survival odds.

That's why new ways to detect the disease earlier are so desperately needed.

Japanese scientists have developed a way to measure metabolites, or chemicals that are produced by the metabolism. People who have more of specific metabolites are more likely to have pancreatic cancer, the researchers found.

Masaru Yoshida, MD, PhD, associate professor and chief of the Division of Metabolomics Research at Kobe University Graduate School of Medicine in Kobe, Japan, said, "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."

The study involved 43 patients with pancreatic cancer and 42 healthy individuals in the initial test group. Another 42 pancreatic cancer patients and 41 healthy volunteers made up another group used to confirm or validate findings from the first group.

Using sophisticated testing technology called gas chromatography mass spectrometry, researchers measured levels of metabolites taken from blood samples from three groups of patients: those with pancreatic cancer, people with chronic pancreatitis (painful inflammation of the pancreas) and healthy volunteers.

Scientists found that the levels of 18 specific metabolites were very different in those with pancreatic cancer as compared to healthy individuals.

Using this data, researchers fine-tuned the test to four metabolites that accurately predicted a pancreatic cancer diagnosis.

Scientists looked at how often the test accurately showed the presence of the disease; this is called sensitivity. Specificity, or how often the test accurately showed the disease was not present, was also measured.

In the original group, the test had 86 percent sensitivity and 88.1 percent specificity. When the test was repeated and patients with chronic pancreatitis were included, the sensitivity was 71.4 percent and specificity was 78.1 percent.

"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," Dr. Yoshida said in a press release. "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 [can be surgically removed] and curable state."

"It is a promising method for improving the prognosis of pancreatic cancer via its early detection and accurate discrimination from chronic pancreatitis," the authors concluded.

This study was published March 29 in Cancer Epidemiology, Biomarkers & Prevention, a publication of the American Association of Cancer Research.

This study was supported by the Global COE Program, Global Center of Excellence for Education and Research on Signal Transduction Medicine in the Coming Generation from the Ministry of Education, Culture, Sports, Science, and Technology of Japan; the Japan Society for the Promotion of Science Fellows; Research on Applying Health Technology from the Ministry of Health, Labour, and Welfare of Japan. No conflicts of interest were declared.

Review Date: 
April 1, 2013