Clinical usefulness of pentraxin 3 (PTX3) as a biomarker of acute pancreatitis and pancreatic cancer

Abstract

Introduction: Increased concentrations of pentraxin 3 (PTX 3) were diagnosed in acute pancreatitis (AP) and in pancreatic ductal adenocarcinoma (PDAC). Aim of the research: To assess of the clinical usefulness of PTX3 in the early differentiation of AP from PDAC. Material and methods: The test group consisted of 125 patients with AP and 24 people with PDAC, as well as 52 healthy subjects. The following concentrations were tested in plasma: PTX3, C-reactive protein (CRP), interleukin-6 (IL-6), and CA-19.9. Results: The mean PTX3 concentration in the moderately-severe AP (MAP) or severe AP (SAP) equalled 16.53 ng/ml and was significantly higher in comparison with mild AP (9.60 ng/ml; p = 0.0007) and the control group (2.31 ng/ml). In the case of patients with PDAC, the mean concentration of PTX3 was 9.20 ng/ml and was significantly higher than in the control group (2.31 ng/ml); p < 0.0001. A significantly higher average CRP value of 100.37 mg/l and IL-6 91.65 pg/ml was also found in patients with PDAC compared to the control group (p < 0.0001). Tested pro-inflammatory cytokines were significantly higher in patients with MAP or SAP than in those with PDAC (p < 0.05). The ROC curve confirms the clear connection of PTX3 level and PDAC in comparison with the control group (p = 0.0001), relatively low sensitivity, and high specificity. However, the results were not significant enough to allow us to differentiate cancer from AP (p > 0.05). Conclusions: Pentraxin 3 can be a marker in the prediction of the severe course of AP, but its clinical usefulness for the differentiation of PDAC was not confirmed. Streszczenie Wprowadzenie: Podwyższone stężenie pentraksyny 3 (PTX3) stwierdzono zarówno w ostrym zapaleniu trzustki (AP), jak i raku trzustki (PDAC). Cel pracy: Ocena przydatności klinicznej PTX3 we wczesnym różnicowaniu AP i PDAC. Materiał i metody: Zbadano 125 chorych na AP i 24 chorych z potwierdzonym histopatologicznie lub cytologicznie PDAC oraz 52 osoby zdrowe jako grupę kontrolną. Próbkę krwi pobierano w pierwszym dniu hospitalizacji. Oznaczono stężenia w osoczu PTX3, białka C-reaktywnego (CRP), interleukiny (IL-6) i aktywność CA-19.9. Wyniki: Średnie stężenie PTX3 u pacjentów z umiarkowanie ciężkim AP (MAP) i ciężkim AP (SAP) wynosiło 16,53 ±15,73 ng/ml i było istotnie wyższe niż średnie stężenia u pacjentów z łagodnym AP (9,60 ±9,65 ng/ml; p = 0,0007) i z grupy kontrolnej (2,31 ±0,58 ng/ml). Średnie stężenie PTX3 u chorych z PDAC wynosiło 9,20 ng/ml i było znacząco większe niż stężenie w grupie kontrolnej (2,31 ng/ml); p < 0,0001. Stwierdzono również istotnie wyższą średnią wartość CRP 100,37 mg/l i IL-6 91,65 pg/ml u chorych z PDAC w porównaniu z grupą osób zdrowych (p < 0,0001). Stężenia cytokin prozapalnych były znamiennie wyższe u chorych z MAP i SAP niż z PDAC (p < 0,05). Krzywa ROC potwierdza istotną zależność między stężeniem PTX3 a rozpoznaniem PDAC w porównaniu z grupą kontrolną, ze stosunkowo niską czułością i wysoką specyficznością. Nie wykazano istotnej zdolności do różnicowania PDAC z AP (p > 0,05). ...

Diagnostic Accuracy of Blood-based Biomarkers for Pancreatic Cancer: A Systematic Review and Meta-analysis

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Postoperative kinetics of pentraxin 3 (PTX3) after congenital heart surgery with cardiopulmonary bypass in pediatric patients

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