The metabolic time line of pancreatic cancer: Opportunities to improve early detection of adenocarcinoma

Am J Surg. 2019 Dec;218(6):1206-1212. doi: 10.1016/j.amjsurg.2019.08.015. Epub 2019 Aug 27.

Abstract

Background: A reliable biomarker to detect pancreatic ductal adenocarcinoma (PDAC) continues to be elusive. With employing metabolomics we hypothesize that a broader analysis of systemic blood can differentiate different stages of PDAC.

Methods: Patients undergoing pancreatic resection had plasma samples grouped by diagnosis and assayed with mass spectrometry. 10 per group [neuroendocrine (PNET), intraductal papillary mucinous neoplasm (IPMN), localized PDAC, locally advanced PDAC, and metastatic] were analyzed to assess if metabolites could delineation different stages of adenocarcinoma.

Results: Of the 215 metabolites measured, four had a stronger correlation to disease burden than CA19-9. However, none of these metabolites differentiated stepwise progression in malignancy. Principal component analysis identified five metabolic components. Each cancer cohort was characterized by a unique combination of components, two components were predictors of PDCA stages.

Conclusions: Enhanced metabolomic analysis identified metabolic pathways that may assist in differentiating PDCA stages that do not occur in a linear stepwise progression.

Keywords: CA19-9; Metabolomics; Pancreatic cancer; Screening.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / diagnosis
  • Adenocarcinoma / metabolism*
  • Adenocarcinoma / surgery
  • Aged
  • Biomarkers, Tumor / blood*
  • Early Detection of Cancer*
  • Female
  • Humans
  • Male
  • Mass Spectrometry
  • Metabolomics / methods*
  • Middle Aged
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / metabolism*
  • Pancreatic Neoplasms / surgery

Substances

  • Biomarkers, Tumor