Early Detection of Sporadic Pancreatic Cancer

Chari, Suresh T.; Kelly, Kimberly A.; Hollingsworth, Michael A.; Thayer, Sarah P.; Ahlquist, David A.; Andersen, Dana K.; Batra, Surinder K.; Brentnall, Teresa A.; Canto, Marcia Irene; Cleeter, Deborah; Firpo, Matthew A.; Gambhir, Sanjiv S.; Go, Vay Liang W.; Hines, Oscar J.; Kenner, Barbara; Klimstra, David S.; Lerch, Markus M.; Levy, Michael J.; Maitra, Anirban; Mulvihill, Sean J.; Petersen, Gloria M.; Rhim, Andrew D.; Simeone, Diane M.; Srivastava, Sudhir; Tanaka, Masao; Vinik, Aaron I.; Wong, Donald

doi:10.1097/mpa.0000000000000368

Cited by 268 publications

(225 citation statements)

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“…Imaging modalities, notably endoscopic ultrasound and magnetic resonance cholangiopancreatography, are currently used in the workup of subjects with suspected PDAC or at high risk for the disease (3). However, known risk factors have only a modest effect on PDAC incidence (4).…”

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confidence: 99%

Sequential Validation of Blood-Based Protein Biomarker Candidates for Early-Stage Pancreatic Cancer

Capello

Bantis

Scélo

et al. 2016

JNCI J Natl Cancer Inst

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Background: CA19-9, which is currently in clinical use as a pancreatic ductal adenocarcinoma (PDAC) biomarker, has limited performance in detecting early-stage disease. We and others have identified protein biomarker candidates that have the potential to complement CA19-9. We have carried out sequential validations starting with 17 protein biomarker candidates to determine which markers and marker combination would improve detection of early-stage disease compared with CA19-9 alone. Methods: Candidate biomarkers were subjected to enzyme-linked immunosorbent assay based sequential validation using independent multiple sample cohorts consisting of PDAC cases (n ¼ 187), benign pancreatic disease (n ¼ 93), and healthy controls (n ¼ 169). A biomarker panel for early-stage PDAC was developed based on a logistic regression model. All statistical tests for the results presented below were one-sided. Results: Six out of the 17 biomarker candidates and CA19-9 were validated in a sample set consisting of 75 PDAC patients, 27 healthy subjects, and 19 chronic pancreatitis patients. A second independent set of 73 early-stage PDAC patients, 60 healthy subjects, and 74 benign pancreatic disease patients (combined validation set) yielded a model that consisted of TIMP1, LRG1, and CA19-9. Additional blinded testing of the model was done using an independent set of plasma samples from 39 resectable PDAC patients and 82 matched healthy subjects (test set). The model yielded areas under the curve (AUCs) of 0.949 (95% confidence interval [CI] ¼ 0.917 to 0.981) and 0.887 (95% CI ¼ 0.817 to 0.957) with sensitivities of 0.849 and 0.667 at 95% specificity in discriminating early-stage PDAC vs healthy subjects in the combined validation and test sets, respectively. The performance of the biomarker panel was statistically significantly improved compared with CA19-9 alone (P < .001, combined validation set; P ¼ .008, test set).

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confidence: 99%

Sequential Validation of Blood-Based Protein Biomarker Candidates for Early-Stage Pancreatic Cancer

Capello

Bantis

Scélo

et al. 2016

JNCI J Natl Cancer Inst

Self Cite

123

125

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“…Screening and prevention efforts can reduce mortality due to cancer. Screening detects abnormalities before they are clinically apparent, thereby enabling intervention before cancer has developed or at an early stage, when treatment is most effective 4, 5. However, susceptible population groups for whom screening should be recommended have not been determined.…”

Section: Introductionmentioning

confidence: 99%

Recurrent aphthous stomatitis may be a precursor or risk factor for specific cancers: A case‐control frequency‐matched study

et al. 2018

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BackgroundRecurrent aphthous stomatitis (RAS) is considered a prophase symptom in patients with specific cancers. This study assessed the association between RAS and subsequent onset of cancer based on a nationwide population‐based database in Taiwan.Materials and MethodsWe selected study participants from the National Health Insurance Research Database from January 2000 to December 2008. Patients in the non‐RAS cohort were matched to case study patients at a 1:1 ratio through frequency matching. All participants were followed up for at least 5 years, and those who received cancer diagnoses during follow‐up were identified.ResultsAmong 52 307 patients with and 52 304 patients without RAS, the combined hazard ratio (HR) of all subsequent cancer cases was 1.3 (95% confidence interval [CI]: 1.25‐1.35, P = 0). RAS diagnosis was associated with risk for cancers of the head and neck (aHR = 2, 95% CI: 1.8‐2.3), colon (aHR = 1.2, 95% CI: 1.1‐1.4), liver (aHR = 1.1, 95% CI: 1‐1.3), pancreas (aHR = 1.4, 95% CI: 1.1‐1.7), skin (aHR = 1.4, 95% CI: 1.2‐1.7), breast (aHR = 1.2, 95% CI: 1.1‐1.4), and prostate (aHR = 1.5, 95% CI: 1.3‐1.8), as well as hematologic cancers (aHR = 1.6, 95% CI: 1.3‐1.9). A higher risk was observed for male patients (aHR = 1.35, 95% CI: 1.28‐1.42) than for female patients (aHR = 1.25, 95% CI: 1.18‐1.31) with RAS.Conclusions RAS was associated with specific cancers. Susceptible RAS patients should be screened for specific cancers.

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“…Both techniques may help to overcome the limitations of conventional EUS imaging; however in this setting, additional studies are required. [14] The potential strength of EUS-FNA however is not only related to the diagnostic purpose. Detailed knowledge of the natural history of the disease and molecular events leading to its progression are critical.…”

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confidence: 99%

“…CPCs have been shown to have a relatively high sensitivity and specificity for identify PC patients versus control subjects; however, in patients with precancerous lesion, these cells alone have not been predictive in determining those patients who will develop cancer. [14] Finally, we have to say that in everyday clinical practice, patients with premalignant lesions of the pancreas or subjects with a genetic risk of PC who seek medical advice represent a real clinical challenge for pancreatologists. On one hand, there is a clear need to offer concrete advice to our patients, while on the other hand, there is the pressing need to increase our knowledge about the natural history and biology of the lesions under scrutiny.…”

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confidence: 99%