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Spectrometry Model as a Diagnostic Marker for Pancreatic Cancer

Japanese researchers including Yoshida and colleagues from the Kobe University Graduate School of Medicine used a specific lab method (gas chromatography mass spectrometry) on certain serum metabolite levels in patients with known pancreatitis, diagnosed pancreatic cancer (ductal adenocarcinoma of the pancreas), and healthy subject volunteers.

The results of this study were published this month in the journal Cancer Epidemiology, Biomarkers & Prevention, a publication of the American Association for Cancer Research (and co-sponsored by the American Society of Preventive Oncology).

In comparing the test results of the serum of the 43 patients with pancreatic cancer versus those of the 42 healthy subjects, the spectrometry model showed both high sensitivity (86%) and high specificity (88.1%).  When additionally looking at the patients with pancreatitis, the model was able to significantly differentiate between pancreatic cancer and pancreatitis.

This is an early study, but one of great promise.  The quest for determining accurate non-invasive methods for the earlier diagnosis (and even screening) for pancreatic cancer is paramount. These results move this aim closer. The methods outlined in this research are important enough to require additional study and refinement.

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Dale O’Brien, MD

MicroRNAs as markers for IPMNs (early pancreatic cancer?)

Intraductal papillary mucinous neoplasms (IPMNs) are not fully understood, but are felt by many to be precursor tumors to full blown pancreatic cancer (ductal adenocarcinoma of the pancreas).

Thus, an interesting study was recently published by Italian researchers including Giovannetti and colleagues from the University of Pisa in the Annals of Oncology (the official journal of the European Society for Medical Oncology – ESMO) which examined the possible role of microRNAs as biomarkers for IPMNs.

The researchers examined and compared miR-21, miR-101, and miR-155 levels in 86 biopsy specimens of IPMNs. They additionally looked at relationships between these levels and overall survival and disease-free survival of the patients with these IPMNs.

The one microRNA that appeared to offer prognostic value as a biomarker in terms of IPMN risk was miR-21. The authors suggest that these results (especially involving miR-21) be further examined in future studies.

Further research into the role of miRNAs, these small 22-nucleotide non-coding RNA molecules, as possible biomarkers for pancreatic cancer should be of great interest.

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Dale O’Brien, MD

From What Cells Does Pancreatic Cancer Arise?

Now comes a fascinating study by researchers from UC San Francisco and UC San Diego that tends to refute the common knowledge that pancreatic adenocarcinoma cells arise from genetic mutations in the PANCREATIC DUCT LINING CELLS.

Published in the November 29th 2012 issue of the journal Cancer Cell, Dr. Maike Sander and colleagues have shown that NON-ductal “acinar” cells in the non-hormone aspect of the pancreas can be transformed into what appear to be precursor cells to “ductal adenocarcinoma” (now a misnomer?) under the influence of mutations of the ductal gene Sox9, as accelerated by an additional mutation in the Kras oncogene.

Additionally, the researchers appear to demonstrate that ductal cells themselves tend to be somewhat resistant to the influence of oncogene mutation. These results may give direction to future research for both the treatment and earlier diagnosis of pancreatic cancer.

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Dale O’Brien, MD