Ballehaninna Umashankar K, Chamberlain Ronald S
Department of Surgery, Saint Barnabas Medical Center, 94, Old Short Hills Road, Livingston, NJ, 07039, USA.
Tumour Biol. 2013 Dec;34(6):3279-92. doi: 10.1007/s13277-013-1033-3. Epub 2013 Aug 17.
Pancreatic adenocarcinoma accounts for nearly 90-95% of exocrine malignant tumors of the pancreas. Traditionally, overexpressed proteins/epitopes such as CA 19-9, CA-50, CEA, and many others were being used as pancreatic cancer tumor markers. The main utility of these biomarkers was in the diagnosis of pancreatic cancer as well as to assess response to chemotherapy and to determine prognosis and to predict tumor recurrence. However, these markers had significant limitations such as lack of sensitivity, false-negative results in certain blood groups, as well as false-positive elevation in the presence of obstructive jaundice. To circumvent these limitations, an extraordinary amount of research is being performed to identify an accurate tumor marker or a panel of markers that could aid in the management of the pancreatic cancer. Although this research has identified a large number and different variety of biomarkers, few hold future promise as a preferred marker for pancreatic cancer. This review provides an insight into exciting new areas of pancreatic biomarker research such as salivary, pancreatic juice, and stool markers that can be used as a noninvasive test to identify pancreatic cancer. This manuscript also provides a discussion on newer biomarkers, the role of microRNAs, and pancreatic cancer proteomics, which have the potential to identify a preferred tumor marker for pancreatic adenocarcinoma. This review further elaborates on important genetic changes associated with the development and progression of pancreatic cancer that holds the key for the identification of a sensitive biomarker and which could also serve as a therapeutic target.
胰腺腺癌占胰腺外分泌恶性肿瘤的近90 - 95%。传统上，诸如CA 19 - 9、CA - 50、癌胚抗原（CEA）等多种过表达蛋白/表位被用作胰腺癌肿瘤标志物。这些生物标志物的主要用途在于胰腺癌的诊断、评估化疗反应、确定预后以及预测肿瘤复发。然而，这些标志物存在显著局限性，如缺乏敏感性、在某些血型中出现假阴性结果，以及在存在梗阻性黄疸时出现假阳性升高。为了克服这些局限性，人们正在进行大量研究以确定一种准确的肿瘤标志物或一组标志物，从而有助于胰腺癌的管理。尽管这项研究已经确定了大量且种类各异的生物标志物，但作为胰腺癌首选标志物具有未来前景的却寥寥无几。本综述深入探讨了胰腺癌生物标志物研究中令人兴奋的新领域，如唾液、胰液和粪便标志物，这些可作为识别胰腺癌的非侵入性检测方法。本文还讨论了新型生物标志物、微小RNA的作用以及胰腺癌蛋白质组学，它们有可能确定胰腺癌的首选肿瘤标志物。本综述进一步阐述了与胰腺癌发生和发展相关的重要基因变化，这是识别敏感生物标志物的关键，也可作为治疗靶点。
