The effective treatment of pancreatic cancer relies on the diagnosis of the disease at an early stage, a difficult challenge. One major obstacle in the development of diagnostic biomarkers of early pancreatic cancer has been the dual expression of potential biomarkers in both chronic pancreatitis and cancer. To better understand the limitations of potential protein biomarkers, we used ICAT technology and tandem mass spectrometry-based proteomics to systematically study protein expression in chronic pancreatitis. Among the 116 differentially expressed proteins identified in chronic pancreatitis, most biological processes were responses to wounding and inflammation, a finding consistent with the underlining inflammation and tissue repair associated with chronic pancreatitis. Furthermore 40% of the differentially expressed proteins identified in chronic pancreatitis have been implicated previously in pancreatic cancer, suggesting some commonality in protein expression between these two diseases. Biological network analysis further identified c-MYC as a common prominent regulatory protein in pancreatic cancer and chronic pancreatitis. Lastly five proteins were selected for validation by Western blot and immunohistochemistry. Annexin A2 and insulin-like growth factor-binding protein 2 were overexpressed in cancer but not in chronic pancreatitis, making them promising biomarker candidates for pancreatic cancer. In addition, our study validated that cathepsin D, integrin 1, and plasminogen were overexpressed in both pancreatic cancer and chronic pancreatitis. The positive involvement of these proteins in chronic pancreatitis and pancreatic cancer will potentially lower the specificity of these proteins as biomarker candidates for pancreatic cancer. Altogether our study provides some insights into the molecular events in chronic pancreatitis that may lead to diverse strategies for diagnosis and treatment of these diseases. Molecular & Cellular Proteomics 6:1331-1342,
2007.Pancreatitis is an inflammatory condition of the pancreas that shares many molecular features with pancreatic cancer. Many of the abnormally expressed proteins present in the setting of pancreatic cancer are also abnormally expressed in chronic pancreatitis, providing an unacceptably low level of specificity for use as protein biomarkers and cancer screening. Thus, a major obstacle for the development of biomarkers for early diagnosis of pancreatic cancer has been the dual expression of potential biomarkers in the neoplastic and non-neoplastic setting. It is therefore important to understand the proteins expressed in pancreatitis because they could be a source of false positive biomarkers for pancreatic cancer. Moreover chronic pancreatitis is a risk factor for eventual neoplastic progression. Patients with chronic pancreatitis have a 2-fold increased risk of pancreatic cancer. Understanding the molecular events involved in both diseases may lead to a better understanding of the mechanisms that link them.The DNA and gene expression profile of pancreat...