Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland.
Department of Internal Diseases and Diabetology, Medical University of Lodz, Lodz, Poland.
J Physiol Pharmacol. 2020 Feb;71(1). doi: 10.26402/jpp.2020.1.10. Epub 2020 Jun 13.
Pancreatic ductal adenocarcinoma (PDAC) is characterized by progressive weight loss and nutritional deterioration. Several cytokines, such as activin A and myostatin, ligands of the transforming growth factor-β superfamily, have been shown to influence the pathogenesis of muscle wasting and tumor progression. The aim of our study was to assess the clinical significance of these cytokines in patients with different stages of PDAC. The study included 93 patients: 73 with newly diagnosed PDAC and 20 healthy volunteers as the control group. PDAC patients included 42 diagnosed with non-metastatic pancreatic cancer (stage I - III) and 31 patients with metastatic cancer (stage IV). The peripheral venous blood samples were collected from each patients at the time of cancer diagnosis and plasma concentrations of activin A and myostatin have been measured with an enzyme-linked immunoassay. Forty five patients (61.6%) presented weight loss > 5%, including 24 (57.1%) with stage I - II and 21 (67.7%) with metastatic PDAC (P > 0.05). Plasma levels of activing A were significantly higher in metastatic PDAC patients compared with stage I - III PDAC patients and control group (P < 0.01). The relationship between higher activin A levels and weight loss was also observed (P < 0.05). On the other hand, myostatin was not associated with weight loss in analysed group of patients. In conclusion, the current study demonstrates that high activin A plasma levels at the time of PDAC diagnosis is associated with unintentional weight loss and may be an useful biomarker for identifying patients with metastatic disease. However, further prospective studies are needed to fully explore the clinical significance of myostatin in pathogenesis of progressive weight loss in PDAC patients.
胰腺导管腺癌 (PDAC) 的特征是进行性体重减轻和营养恶化。几种细胞因子，如激活素 A 和肌肉生长抑制素，转化生长因子-β 超家族的配体，已被证明影响肌肉减少症和肿瘤进展的发病机制。我们的研究目的是评估这些细胞因子在不同阶段 PDAC 患者中的临床意义。该研究纳入了 93 名患者：73 名新诊断为 PDAC 的患者和 20 名健康志愿者作为对照组。PDAC 患者包括 42 名诊断为非转移性胰腺癌 (I 期 - III 期) 和 31 名转移性癌症患者 (IV 期)。每位患者在癌症诊断时采集外周静脉血样，并使用酶联免疫吸附试验测量激活素 A 和肌肉生长抑制素的血浆浓度。45 名患者 (61.6%) 出现体重减轻>5%，其中 24 名 (57.1%) 为 I 期 - II 期，21 名 (67.7%) 为转移性 PDAC (P>0.05)。转移性 PDAC 患者的激活素 A 血浆水平明显高于 I 期 - III 期 PDAC 患者和对照组 (P<0.01)。还观察到较高的激活素 A 水平与体重减轻之间的关系 (P<0.05)。另一方面，肌肉生长抑制素与分析组患者的体重减轻无关。总之，目前的研究表明，PDAC 诊断时高激活素 A 血浆水平与非故意体重减轻有关，可能是识别转移性疾病患者的有用生物标志物。然而，需要进一步的前瞻性研究来充分探索肌肉生长抑制素在 PDAC 患者进行性体重减轻发病机制中的临床意义。
