Sato Yu, Kobayashi Takashi, Nishiumi Shin, Okada Akihiko, Fujita Tsuyoshi, Sanuki Tsuyoshi, Kobayashi Masao, Asahara Masakyo, Adachi Masayasu, Sakai Arata, Shiomi Hideyuki, Masuda Atsuhiro, Yoshida Masaru, Takeuchi Keiko, Kodama Yuzo, Kutsumi Hiromu, Nagashima Kengo, Honda Kazufumi
Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 6500017, Japan.
Department of Omics Medicine, Hyogo College of Medicine, Hyogo 6638501, Japan.
Cancers (Basel). 2020 Sep 14;12(9):2625. doi: 10.3390/cancers12092625.
Apolipoprotein A2-ATQ/AT (apoA2-ATQ/AT) has been identified as a minimally invasive biomarker for detecting pancreatic cancer (PC) and high-risk (HR) individuals for PC. To establish an efficient enrichment strategy for HR, we carried out a plasma apoA2-ATQ/AT level-based prospective screening study among the general population. The subjects for the screening study were recruited at six medical check-up facilities in Japan between October 2015 and January 2017. We evaluated the positive predictive value (PPV) of the plasma apoA2-ATQ/AT level of ≤35 μg/mL for detecting PC and HR. Furthermore, we prospectively confirmed its diagnostic accuracy with another post-diagnosis population in a cross-sectional study. We enrolled 5120 subjects in experimental screening, with 84 subjects (1.3%) showing positive results for apoA2-ATQ/AT. Pancreatic abnormalities were recognized in 26 of the 84 subjects from imaging examinations. Pancreatic abnormalities detected included 1 PC and 15 HR abnormalities, such as cystic lesions including intraductal papillary mucinous neoplasm. The PPV of apoA2-ATQ/AT for detecting PC and HR was 33.3%. Moreover, a combination study with another cross-sectional study revealed that the area under the curve for apoA2-ATQ/AT to distinguish PC from healthy controls was 0.903. ApoA2-ATQ/AT has the potential to enrich PC and HR by increasing the diagnostic probability before imaging examinations.
载脂蛋白A2-ATQ/AT（apoA2-ATQ/AT）已被确定为一种用于检测胰腺癌（PC）及PC高危（HR）个体的微创生物标志物。为建立针对HR个体的高效富集策略，我们在普通人群中开展了一项基于血浆apoA2-ATQ/AT水平的前瞻性筛查研究。该筛查研究的受试者于2015年10月至2017年1月期间在日本的六个体检机构招募。我们评估了血浆apoA2-ATQ/AT水平≤35μg/mL用于检测PC和HR个体的阳性预测值（PPV）。此外，我们在一项横断面研究中对另一组确诊后的人群前瞻性地确认了其诊断准确性。我们纳入了5120名受试者进行实验性筛查，其中84名受试者（1.3%）的apoA2-ATQ/AT检测结果呈阳性。在这84名受试者中，通过影像学检查发现26人存在胰腺异常。检测到的胰腺异常包括1例PC和15例HR异常，如导管内乳头状黏液性肿瘤等囊性病变。apoA2-ATQ/AT检测PC和HR个体的PPV为33.3%。此外，与另一项横断面研究的联合研究表明，apoA2-ATQ/AT区分PC与健康对照的曲线下面积为0.903。ApoA2-ATQ/AT有可能通过在影像学检查前提高诊断概率来富集PC和HR个体。
