Franklin Oskar, Öhlund Daniel, Lundin Christina, Öman Mikael, Naredi Peter, Wang Wanzhong, Sund Malin
Department of Surgical and Perioperative Sciences, Umeå, Sweden.
Department of Pathology, Umeå University, Umeå, Sweden.
Cancer Biomark. 2015;15(1):1-10. doi: 10.3233/CBM-140430.
A lack of disease-specific symptoms and good tumour markers makes early detection and diagnosis of pancreatic ductal adenocarcinoma (PDAC) challenging.
To analyse the tissue expression and circulating levels of four stroma-derived substances (type IV collagen, endostatin/type XVIII collagen, osteopontin and tenascin C) and four conventional tumour markers (CA 19-9, TPS, CEA and Ca 125) in a PDAC cohort.
Tissue expression of markers in normal pancreas and PDAC tissue was analysed with immunofluorescence. Plasma concentrations of markers were measured before and after surgery. Patients with non-malignant disorders served as controls.
The conventional and stromal substances were expressed in the cancer cell compartment and the stroma, respectively. Although most patients had increased levels of many markers before surgery, 2/12 (17%) of patients had normal levels of Ca 19-9 at this stage. High preoperative endostatin/type XVIII collagen, and postoperative type IV collagen was associated with short survival. Neither the pre- nor postoperative levels of TPS, Ca 125 or CA 19-9 were associated to survival.
PDAC is characterized by an abundant stroma. These initial observations indicate that the stroma can be a source of PDAC tumour markers that are found in different compartments of the cancer, thus reflecting different aspects of tumour biology.
缺乏疾病特异性症状和良好的肿瘤标志物使得胰腺导管腺癌（PDAC）的早期检测和诊断具有挑战性。
分析胰腺导管腺癌队列中四种基质衍生物质（IV型胶原、内皮抑素/ XVIII型胶原、骨桥蛋白和腱生蛋白C）以及四种传统肿瘤标志物（CA 19-9、TPS、CEA和Ca 125）的组织表达和循环水平。
采用免疫荧光法分析正常胰腺组织和胰腺导管腺癌组织中标志物的表达。在手术前后测定标志物的血浆浓度。以非恶性疾病患者作为对照。
传统标志物和基质衍生物质分别在癌细胞区室和基质中表达。尽管大多数患者在手术前多种标志物水平升高，但在此阶段有2/12（17%）的患者Ca 19-9水平正常。术前内皮抑素/ XVIII型胶原水平高以及术后IV型胶原水平高与生存期短相关。TPS、Ca 125或CA 19-9的术前和术后水平均与生存期无关。
胰腺导管腺癌的特征是富含基质。这些初步观察结果表明，基质可能是胰腺导管腺癌肿瘤标志物的来源，这些标志物存在于癌症的不同区室中，从而反映肿瘤生物学的不同方面。
