Department of Oncology, The First Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, China.
Department of Abdominal Oncology, West China Hospital of Sichuan University, Chengdu, China.
Cancer Med. 2018 Nov;7(11):5525-5533. doi: 10.1002/cam4.1833. Epub 2018 Oct 24.
Carbohydrate antigen 19-9 (CA19-9) fails to demonstrate the predictive value for early detection pancreatic ductal adenocarcinoma (PDAC). Glypican-1 (GPC1+) exosomes may serve as a noninvasive diagnostic tool to detect early stages of PDAC. Therefore, it is necessary to explore the serum GPC1 levels and determine whether serum GPC1 serves as a novel biomarker for PDAC patients. Blood samples were collected from 156 patients with PDAC, 199 non-cancer controls, and 240 patients with other cancers. Serological levels of GPC1 were examined by enzyme-linked immunosorbent assay (ELISA). Finally, a 5-year follow-up was monitored to evaluate the correlation between serum GPC1 levels and overall survival in 156 patients with PDAC. The results suggested that levels of serum GPC1 and CA19-9 were higher in PDAC patients than that of controls (P < 0.05). Serum GPC1 levels in PDAC were different from those in gallbladder carcinoma (P < 0.001), colorectal carcinoma (P < 0.001), gastric carcinoma (P < 0.001), and prostate cancer (P < 0.001), but not hepatocellular carcinoma (P = 0.395) and cholangiocarcinoma (P = 0.724). Receiver operating characteristic curve (ROC) analysis showed that serum CA19-9 was significantly better than serum GPC1 in distinguishing PDAC patients from the controls (AUC, 95% CI: 0.908, 0.868-0.947 vs 0.795, 0.749-0.841, respectively). The serum GPC1 cannot be used as a serum diagnostic biomarker for PDAC patients. The level of serum GPC1 decreased 2 days after surgery (P = 0.001), which were not different from serum GPC1 levels in healthy control (P = 0.381). The overall survival rate was shorter in patients with high levels of serum GPC1 compared to those with low levels of serum GPC1 (log-rank = 5.16, P = 0.023). Taken together, the results indicate that high levels of serum GPC1 predict poor prognosis in PDAC patients. Serum GPC1 may be a prognosis factor for PDAC patients.
糖抗原 19-9（CA19-9）未能证明其对胰腺导管腺癌（PDAC）早期检测的预测价值。磷脂酰肌醇蛋白聚糖-1（GPC1+）外泌体可能作为一种非侵入性诊断工具，用于检测 PDAC 的早期阶段。因此，有必要探讨血清 GPC1 水平，并确定血清 GPC1 是否可作为 PDAC 患者的新型生物标志物。从 156 名 PDAC 患者、199 名非癌症对照者和 240 名其他癌症患者中采集血样。通过酶联免疫吸附测定（ELISA）检测血清 GPC1 水平。最后，对 156 名 PDAC 患者进行了 5 年随访，以评估血清 GPC1 水平与总生存率之间的相关性。结果表明，PDAC 患者的血清 GPC1 和 CA19-9 水平均高于对照组（P<0.05）。PDAC 患者的血清 GPC1 水平与胆囊癌（P<0.001）、结直肠癌（P<0.001）、胃癌（P<0.001）和前列腺癌（P<0.001）不同，但与肝细胞癌（P=0.395）和胆管癌（P=0.724）无差异。受试者工作特征曲线（ROC）分析显示，血清 CA19-9 区分 PDAC 患者与对照组的能力明显优于血清 GPC1（AUC，95%CI：0.908，0.868-0.947 与 0.795，0.749-0.841，分别）。血清 GPC1 不能作为 PDAC 患者的血清诊断生物标志物。手术后 2 天，血清 GPC1 水平下降（P=0.001），与健康对照组的血清 GPC1 水平无差异（P=0.381）。与血清 GPC1 水平较低的患者相比，血清 GPC1 水平较高的患者的总生存率较短（log-rank=5.16，P=0.023）。综上所述，结果表明，血清 GPC1 水平升高预示 PDAC 患者预后不良。血清 GPC1 可能是 PDAC 患者的预后因素。
