Potentials of Plasma NGAL and MIC-1 as Biomarkers in the Diagnosis of Lethal Pancreatic CancerReport as inadecuate

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Pancreatic cancer PC is lethal malignancy with very high mortality rate. Absence of sensitive and specific markers is one of the major factors for poor prognosis of PC patients. In pilot studies using small set of patients, secreted acute phase proteins neutrophil gelatinase associated lipocalin NGAL and TGF-β family member macrophage inhibitory cytokine-1 MIC-1 are proposed as most potential biomarkers specifically elevated in the blood of PC patients. However, their performance as diagnostic markers for PC, particularly in pre-treatment patients, remains unknown. In order to evaluate the diagnostic efficacy of NGAL and MIC-1, their levels were measured in plasma samples from patients with pre-treatment PC patients n = 91 and compared it with those in healthy control HC individuals n = 24 and patients with chronic pancreatitis CP, n = 23. The diagnostic performance of these two proteins was further compared with that of CA19-9, a tumor marker commonly used to follow PC progression. The levels of all three biomarkers were significantly higher in PC compared to HCs. The mean ± standard deviation, SD plasma NGAL, CA19-9 and MIC-1 levels in PC patients was 111.1 ng-mL 2.2, 219.2 U-mL 7.8 and 4.5 ng-mL 4.1, respectively. In comparing resectable PC to healthy patients, all three biomarkers were found to have comparable sensitivities between 64%-81% but CA19-9 and NGAL had a higher specificity 92% and 88%, respectively. For distinguishing resectable PC from CP patients, CA19-9 and MIC-1 were most specific 74% and 78% respectively. CA19-9 at an optimal cut-off of 54.1 U-ml is highly specific in differentiating resectable stage 1-2 pancreatic cancer patients from controls in comparison to its clinical cut-off 37.1 U-ml. Notably, the addition of MIC-1 to CA19-9 significantly improved the ability to distinguish resectable PC cases from CP p = 0.029. Overall, MIC-1 in combination with CA19-9 improved the diagnostic accuracy of differentiating PC from CP and HCs.

Author: Sukhwinder Kaur , Subhankar Chakraborty , Michael J. Baine , Kavita Mallya , Lynette M. Smith, Aaron Sasson, Randall Brand, Susho

Source: http://plos.srce.hr/


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