Dilemma and solution in diagnosing pancreatic cancer
DOI: 217 Downloads 5877 Views
Author(s)
Abstract
Pancreatic cancer is projected to become the second most common cause of cancer-related death in the United States in 2030, overtaking deaths from breast and colon cancers. Although increased screening has led to improvements in the detection of certain cancers such as colorectal cancer, the same is not true for pancreatic cancer. The diagnosis of pancreatic cancer, especially early-stage pancreatic cancer, is still challenging for clinicians. In spite of progresses in our understanding of the carcinogenesis of pancreatic cancer, improved resolution of imaging equipment, and development of screening methods based on molecular biology, the prognosis of patients with pancreatic cancer is still poor. The most promising method of increasing the survival rate of patients with pancreatic cancer is early-stage detection. However, the diagnosis of pancreatic cancer is difficult because of nonspecific symptoms in early cases and the lack of effective diagnostic tools. We look forward to new biomarkers with good sensitivity and specificity or new combinations of existing biomarkers to improve sensitivity or specificity for pancreatic cancer diagnosis. Advances in the field of imaging technique should make high-resolution equipment available in the future, and we hope that new imaging modalities combined with various contrasts would increase diagnostic effectiveness for pancreatic cancer.
Keywords
pancreatic cancer; biomarker; imaging
Cite this paper
Xiao-Dong Shao,
Dilemma and solution in diagnosing pancreatic cancer
, SCIREA Journal of Clinical Medicine.
Volume 4, Issue 5, October 2019 | PP. 123-142.
References
[ 1 ] | Raimondi S, Maisonneuve P, Lowenfels AB. Epidemiology of pancreatic cancer: an overview. Nat Rev Gastroenterol Hepatol 2009 ;6(12):699–708. |
[ 2 ] | Siegel R, Naishadham D, Jemal A. Cancer statistics. CA Cancer J Clin 2012 ;62(1):10–29. |
[ 3 ] | Ries LAG, Eisner MP, Kosary CL. eds. SEER Cancer Statistics Review, 1975–2000. National Cancer Institute 2003. |
[ 4 ] | Rieder H, Bartsch DK. Familial pancreatic cancer. Fam Cancer 2004;3:69–74. |
[ 5 ] | Klein AP, Hruban RH, Brune KA, et al. Familial pancreatic cancer. Cancer J 2001;7: 266–273. |
[ 6 ] | Lillemoe KD, Yeo CJ, Cameron JL. Pancreatic cancer: state-of-theartcare. CA Cancer J Clin 2000;50: 241–268. |
[ 7 ] | Everhart J, Wright D. Diabetes mellitus as a risk factor for pancreatic cancer. A meta-analysis. JAMA 1995;273: 1605–1609. |
[ 8 ] | Li D, Xie K, Wolff R, et al. Pancreatic cancer. Lancet 2004;363: 1049–1057. |
[ 9 ] | O’Reilly EM, Lowery MA. Postresection surveillance for pancreatic cancer performance status, imaging, and serum markers. Cancer J 2012; 18: 609-613. |
[ 10 ] | Glenn J, Steinberg WM, Kurtzman SH, et al. Evaluation of the utility of a radioimmunoassay for serum CA 19-9 levels in patients before and after treatment of carcinoma of the pancreas. J Clin Oncol 1988; 6: 462-468. |
[ 11 ] | Berger AC, Garcia M Jr, Hoffman JP, et al. Postresection CA 19-9 predicts overall survival in patients with pancreatic cancer treated with adjuvant chemoradiation: a prospective validation by RTOG 9704. J Clin Oncol 2008; 26: 5918-5922. |
[ 12 ] | Goonetilleke KS, Siriwardena AK. Systematic review of carbohydrate antigen (CA 19-9) as a biochemical marker in the diagnosis of pancreatic cancer. Eur J Surg Oncol 2007;33: 266–270. |
[ 13 ] | Meng Q, Shi S, Liang C,et al. Diagnostic and prognostic value of carcinoembryonic antigen in pancreatic cancer: a systematic review and meta-analysis. OncoTargets and Therapy 2017;10 :4591–4598. |
[ 14 ] | Streppel MM, Vincent A, Mukherjee R, et al. Mucin 16 (cancer antigen 125) expression in human tissues and cell lines and correlation with clinical outcome in adenocarcinomas of the pancreas, esophagus, stomach, and colon. Hum Pathol 2012; 43: 1755-1763. |
[ 15 ] | Luo G, Xiao Z, Long J, et al. CA125 is Superior to CA19-9 in Predicting the Resectability of Pancreatic Cancer. J Gastrointest Surg 2013; 17: 2092-2098. |
[ 16 ] | Einama T, Kamachi H, Nishihara H, et al. Co-expression of mesothelin and CA125 correlates with unfavorable patient outcome in pancreatic ductal adenocarcinoma. Pancreas 2011; 40: 1276-1282. |
[ 17 ] | Hogendorf P, Durczyński A, Skulimowski A, et al. Growth differentiation factor (GDF-15) concentration combined with Ca125 levels in serum is superior to commonly used cancer biomarkers in differentiation of pancreatic mass. Cancer Biomark 2017 Nov 17. doi: 10.3233/CBM-170203. |
[ 18 ] | Whiteside TL. Profiling of plasma-derived extracellular vesicles cargo for diagnosis of pancreatic malignancy. Ann Transl Med 2017;5(24):501. |
[ 19 ] | Takayama R, Nakagawa H, Sawaki A, et al. Serum tumor antigen REG4 as a diagnostic biomarker in pancreatic ductal adenocarcinoma. J Gastroenterol 2010; 45: 52-59. |
[ 20 ] | Takano S, Sogawa K, Yoshitomi H, et al. Increased circulating cell signalling phosphoproteins in sera are useful for the detection of pancreatic cancer. Br J Cancer 2010; 103: 223-231. |
[ 21 ] | Wang F, Chen L, Ding W, et al. Serum APRIL, a potential tumor marker in pancreatic cancer. Clin Chem Lab Med 2011; 49: 1715-1719. |
[ 22 ] | Kosanam H, Prassas I, Chrystoja CC, et al. Laminin, gamma 2 (LAMC2): a promising new putative pancreatic cancer biomarker identified by proteomic analysis of pancreatic adenocarcinoma tissues. Mol Cell Proteomics 2013; 12: 2820-2832. |
[ 23 ] | Banaei N, Foley A, Houghton JM,et al. Multiplex detection of pancreatic cancer biomarkers using a SERS-based immunoassay. Nanotechnology 2017 Nov 10;28(45):455101. doi: 10.1088/1361-6528/aa8e8c. |
[ 24 ] | Chen R, Crispin DA, Pan S, et al. Pilot study of blood biomarker candidates for detection of pancreatic cancer. Pancreas 2010;39: 981–988. |
[ 25 ] | Meng Q, Shi S, Liang C,et al. Diagnostic Accuracy of a CA125-Based Biomarker Panel in Patients with Pancreatic Cancer: A Systematic Review and Meta-Analysis. J Cancer 2017, 8(17): 3615-3622. |
[ 26 ] | Brand RE, Nolen BM, Zeh HJ, et al. Serum biomarker panels for the detection of pancreatic cancer. Clin Cancer Res 2011;17: 805–816. |
[ 27 ] | Liu X, Zheng W, Wang W, et al. A new panel of pancreatic cancer biomarkers discovered using a mass spectrometry-based pipeline. Br J Cancer 2017,5;117(12):1846-1854. |
[ 28 ] | Mayers JR, Wu C, Clish CB, et al. Elevation of circulating branched-chain amino acids is an early event in human pancreatic adenocarcinoma development. Nat Med 2014 ;20(10):1193-1198. |
[ 29 ] | He XY, Yuan YZ. Advances in pancreatic cancer research: moving towards early detection. World J Gastroenterol. 2014 ;20(32):11241-11248. |
[ 30 ] | Lei L, Wang J, Zhang L, et al. Meta-analysis of the clinical value of abnormally expressed long non-coding RNAs for pancreatic cancer. Oncotarget, 2017, 8,(51), 89149-89159. |
[ 31 ] | Yang F, Liu DY, Guo JT, et al. Circular RNA circ-LDLRAD3 as a biomarker in diagnosis of pancreatic cancer. World J Gastroenterol 2017 December 21; 23(47): 8345-8354. |
[ 32 ] | Goonesekere NC, Wang X, Ludwig L, et al. A meta analysis of pancreatic microarray datasets yields new targets as cancer genes and biomarkers. PLoS One. 2014 ;9(4):e93046. |
[ 33 ] | Liao Q, Zhao YP, Yang YC, et al. Combined detection of serum tumor markers for differential diagnosis of solid lesions located at the pancreatic head. Hepatobiliary Pancreat Dis Int 2007; 6: 641-645. |
[ 34 ] | Chang CL, Hsu MY. The study that applies artificial intelligence and logistic regression for assistance in differential diagnostic of pancreatic cancer. Expert Syst Appl 2009; 36: 10663-10672. |
[ 35 ] | Yang Y, Chen H, Wang D, et al. Diagnosis of pancreatic carcinoma based on combined measurement of multiple serum tumor markers using artificial neural network analysis. Chin Med J (Engl). 2014 ;127(10):1891-1896. |
[ 36 ] | Mikata R, Ishihara T, Tada M, et al. Clinical usefulness of repeated pancreatic juice cytology via endoscopic naso-pancreatic drainage tube in patients with pancreatic cancer. J Gastroenterol 2013; 48: 866-873. |
[ 37 ] | Stewart CJ, Mills PR, Carter R, et al. Brush cytology in the assessment of pancreatico-biliary strictures: a review of 406 cases. J Clin Pathol 2001; 54: 449-455. |
[ 38 ] | Zhou L, Lu Z, Yang A, et al. Comparative proteomic analysis of human pancreatic juice: methodological study. Proteomics 2007; 7: 1345-1355. |
[ 39 ] | Kanda M, Knight S, Topazian M, et al. Mutant GNAS detected in duodenal collections of secretin-stimulated pancreatic juice indicates the presence or emergence of pancreatic cysts. Gut 2013;62:1024–1033. |
[ 40 ] | Matsubayashi H, Canto M, Sato N, et al. DNA methylation alterations in the pancreatic juice of patients with suspected pancreatic disease. Cancer Res 2006;66: 1208–1217. |
[ 41 ] | Yao F, Sun M, Dong M, et al. NPTX2 hypermethylation in pure pancreatic juice predicts pancreatic neoplasms. Am J Med Sci 2013;346: 175–180. |
[ 42 ] | Cheever MA, Allison JP, Ferris AS, et al. The prioritization of cancer antigens: a national cancer institute pilot project for the acceleration of translational research. Clin Cancer Res 2009;15: 5323–5337. |
[ 43 ] | Osako M, Yonezawa S, Siddiki B, et al. Immunohistochemical study of mucin carbohydrates and core proteins in human pancreatic tumors. Cancer 1993;71: 2191–2199. |
[ 44 ] | Yokoyama S, Kitamoto S, Higashi M, et al. Diagnosis of pancreatic neoplasms using a novel method of DNA methylation analysis of mucin expression in pancreatic juice. PLoS One. 2014 ;9(4):e93760. |
[ 45 ] | Kisiel JB, Yab TC, Taylor WR, et al. Stool DNA testing for the detection of pancreatic cancer: assessment of methylation marker candidates. Cancer 2012;118(10):2623-2631. |
[ 46 ] | Roy R, Zurakowski D, Wischhusen J, et al. Urinary TIMP-1 and MMP-2 levels detect the presence of pancreatic malignancies. Br J Cancer 2014 ;111(9):1772-1779. |
[ 47 ] | Arasaradnam R, Wicaksono A, O'Brien H, et al. Non-invasive diagnosis of pancreatic cancer through detection of volatile organic compounds in urine. Gastroenterology 2017 Nov 9. pii: S0016-5085(17)36347-3. doi:10.1053/j.gastro.2017.09.054. |
[ 48 ] | Zhang L, Farrell JJ, Zhou H, et al. Salivary transcriptomic biomarkers for detection of resectable pancreatic cancer. Gastroenterology 2010 ;138(3):949-957. |
[ 49 ] | Kinney T. Evidence-based imaging of pancreatic malignancies. Surg Clin North Am 2010; 90: 235-249 |
[ 50 ] | Taylor B. Carcinoma of the head of the pancreas versus chronic pancreatitis: diagnostic dilemma with significant consequences. World J Surg 2003; 27: 1249-1257. |
[ 51 ] | Frulloni L, Falconi M, Gabbrielli A, et al. Italian consensus guidelines for chronic pancreatitis. Dig Liver Dis 2010; 42 Suppl 6: S381-406. |
[ 52 ] | Bipat S, Phoa SS, van Delden OM. Ultrasonography, computed tomography and magnetic resonance imaging for diagnosis and determining resectability of pancreatic adenocarcinoma: a meta-analysis. J Comput Assist Tomogr 2005 ;29(4):438–445. |
[ 53 ] | Canto MI, Hruban RH, Fishman EK, et al. Frequent detection of pancreatic lesions in asymptomatic highrisk individuals. Gastroenterology 2012;142:796–804. |
[ 54 ] | Balci NC, Semelka RC. Radiologic diagnosis and staging of pancreatic ductal adenocarcinoma. Eur J Radiol 2001;38:105–112. |
[ 55 ] | Gonzalo-Marin J, Vila JJ, Perez-Miranda M. Role of endoscopic ultrasound in the diagnosis of pancreatic. World J Gastrointest Oncol 2014 ; 6(9): 360-368. |
[ 56 ] | Owens DJ, Savides TJ. Endoscopic ultrasound staging and novel therapeutics for pancreatic cancer. Surg Oncol Clin N Am 2010; 19: 255-266. |
[ 57 ] | Dietrich CF, Arcidiocono PG, Carrar S. Pancreatic adenocarcinoma: Role in Endoscopic Ultrasound. In: Endoscopic Ultrasound. An Introductory Manual and Atlas. Christoph F. Dietrich, ed. Colombia: AMOLCA Editorial, 2009: 196-204. |
[ 58 ] | Eloubeidi MA, Tamhane A. Prospective assessment of diagnostic utility and complications of endoscopic ultrasoundguided fine needle aspiration. Results from a newly developed academic endoscopic ultrasound program. Dig Dis 2008; 26: 356-363. |
[ 59 ] | David O, Green L, Reddy V. Pancreatic masses: a multiinstitutional study of 364 fine-needle aspiration biopsies with histopathologic correlation. Diagn Cytopathol 1998;19:423-427. |
[ 60 ] | Jing X, Wamsteker EJ, Li H, et al. Combining fine needle aspiration with brushing cytology has improved yields in diagnosing pancreatic ductal adenocarcinoma. Diagn Cytopathol 2009;37:574-578. |
[ 61 ] | Iglesias-Garcia J, Dominguez-Munoz JE, Abdulkader I,et al. Influence of on-site cytopathology evaluation in the diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of solid pancreatic masses. Am J Gastroenterol 2011; 106: 1705-1710. |
[ 62 ] | Alsohaibani F, Girgis S, Sandha GS. Does onsite cytotechnology evaluation improve the accuracy of endoscopic ultrasound-guided fine-needle aspiration biopsy? Can J Gastroenterol 2009; 23: 26-30. |
[ 63 ] | Jhala N, Jhala D, Vickers SM. Biomarkers in diagnosis of pancreatic carcinoma in fine-needle aspirates. Am J Clin Pathol 2006;126:572-579. |
[ 64 ] | Xiao W, Hong H, Awadallah A, et al. CRABP-II is a highly sensitive and specific diagnostic molecular marker for pancreatic ductal adenocarcinoma in distinguishing from benign pancreatic conditions. Hum Pathol. 2014 ;45(6):1177-1183. |
[ 65 ] | Miller FH, Rini NJ, Keppke AL. MRI of adenocarcinoma of the pancreas. AJR Am J Roentgenol 2006; 187(4):W365–74. |
[ 66 ] | Birchard KR, Semelka RC, Hyslop WB. Suspected pancreatic cancer: evaluation by dynamic gadolinium-enhanced 3D gradient-echo MRI. AJR Am J Roentgenol 2005;185(3):700–3. |
[ 67 ] | Ly JN, Miller FH. MR imaging of the pancreas: a practical approach. Radiol Clin North Am 2002; 40(6):1289–1306. |
[ 68 ] | Wang Y, Chen ZE, Nikolaidis P. Diffusionweighted magnetic resonance imaging of pancreatic adenocarcinomas: association with histopathology and tumor grade. J Magn Reson Imaging 2011; 33(1):136–142. |
[ 69 ] | Ichikawa T, Erturk SM, Motosugi U. High-b value diffusion-weighted MRI for detecting pancreatic adenocarcinoma: preliminary results. AJR Am J Roentgenol 2007;188(2):409–414. |
[ 70 ] | Liu K, Xie P, Peng W, et al. Assessment of dynamic contrast-enhanced magnetic resonance imaging in the differentiation of pancreatic ductal adenocarcinoma from other pancreatic solid lesions. J Comput Assist Tomogr. 2014;38(5):681-686. |
[ 71 ] | Buchs NC, Buhler L, Bucher P. Value of ontrast-enhanced 18F-fluorodeoxyglucose positron emission tomography/computed tomography in detection and presurgical assessment of pancreatic cancer: a prospective study. J Gastroenterol Hepatol 2011;26(4): 657–662. |
[ 72 ] | Boellaard R, O’Doherty MJ, Weber WA. FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0. Eur J Nucl Med Mol Imaging 2010 ; 37(1):181–200. |
[ 73 ] | Pakzad F, Groves AM, Ell PJ. The role of positron emission tomography in the management of pancreatic cancer. Semin Nucl Med 2006 ;36(3):248–256. |
[ 74 ] | Bang S, Chung HW, Park SW, et al. The clinical usefulness of 18-fluorodeoxyglucose positron emission tomography in the differential diagnosis, staging, and response evaluation after concurrent chemoradiotherapy for pancreatic cancer. J Clin Gastroenterol 2006; 40(10):923–929. |
[ 75 ] | Delbeke D, Rose DM, Chapman WC. Optimal interpretation of FDG PET in the diagnosis, staging and management of pancreatic carcinoma. J Nucl Med 1999;40(11):1784–1791. |
[ 76 ] | Bond-Smith G, Banga N, Hammond TM, et al. Pancreatic adenocarcinoma. BMJ 2012;344:e2476. |
[ 77 ] | Rijkers AP, Valkema R, Duivenvoorden HJ, et al. Usefulness of F-18-fluorodeoxyglucose positron emission tomography to confirm suspected pancreatic cancer: a meta-analysis. Eur J Surg Oncol. 2014 ;40(7):794-804. |
[ 78 ] | Yeh R, Dercle L, Garg I, et al. The Role of 18F-FDG PET/CT and PET/MRI in Pancreatic Ductal Adenocarcinoma. Abdom Radiol (NY). 2017 Nov 16. doi: 10.1007/s00261-017-1374-2. |
[ 79 ] | Thomas C. Risk factors, biomarker and imaging techniques used for pancreatic cancer screening. Chin Clin Oncol 2017;6(6):61. |
[ 80 ] | Wu J, Jiao Y, Dal Molin M, Maitra A, et al. Whole-exome sequencing of neoplastic cysts of the pancreas reveals recurrent mutations in components of ubiquitin-dependent pathways. Proc Natl Acad Sci USA 2011;108:21188–21193. |
[ 81 ] | Wu J, Matthaei H, Maitra A, et al. Recurrent GNAS mutations define an unexpected pathway for pancreatic cyst development. Sci Transl Med 2011;3:92. |
[ 82 ] | Kinde I, Papadopoulos N, Kinzler KW, et al. FAST-SeqS: a simple and efficient method for the detection of aneuploidy by massively parallel sequencing. PLoS One 2012;7:e41162. |