Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.
Fimlab Laboratories, Tampere, Finland.
Scand J Gastroenterol. 2021 Jan;56(1):81-85. doi: 10.1080/00365521.2020.1849383. Epub 2020 Nov 27.
SuPAR (soluble urokinase-type plasminogen activator receptor) is a biomarker reflecting the inflammatory state of the human body. Earlier studies suggest that urinary suPAR/creatinine ratio levels are elevated in chronic pancreatitis (CP), and that plasma suPAR (P-suPAR) level is elevated in pancreatic cancer (PC). Our aim was to study the levels of P-suPAR in CP in a long-term prospective follow-up setting to explore the possibility of distinguishing between PC and CP.
Two patient groups were compared. The first group included 83 patients who were prospectively followed up after their first acute alcohol-induced pancreatitis (AAP) for median 7.0 (range 0.3-9.8) years. Twelve patients in this group developed CP during follow-up, and two patients were further excluded from the CP cohort. The second group consisted of 25 patients operated on for suspicion of pancreatic malignancy and final pathological diagnosis of PC. P-suPAR levels were measured and compared within and between these groups.
P-suPAR levels remained low during follow-up despite the development of CP. P-suPAR was significantly higher in PC patients [median 3.7 (IQR 3.1-4.4) ng/mL] than in CP patients [2.6 (1.8-3.6) ng/mL]; = .014. A cutoff value of 2.8 ng/mL resulted from a ROC curve with area under curve (AUC) of 0.79 (95% CI 0.61-0.97), = .009 in differentiation between PC and CP with a sensitivity and a specificity of 88% and 70% respectively.
P-suPAR is higher in patients with PC than in patients with CP, and it could thus be used in differentiating between PC and CP.
suPAR（可溶性尿激酶型纤溶酶原激活物受体）是反映人体炎症状态的生物标志物。早期研究表明，慢性胰腺炎（CP）患者尿 suPAR/肌酐比值升高，胰腺癌（PC）患者血浆 suPAR（P-suPAR）水平升高。我们的目的是在长期前瞻性随访中研究 CP 患者的 P-suPAR 水平，以探讨其区分 PC 和 CP 的可能性。
比较了两组患者。第一组包括 83 例患者，前瞻性随访了他们首次急性酒精性胰腺炎（AAP）后中位数为 7.0（范围 0.3-9.8）年。该组中有 12 例在随访中发展为 CP，2 例从 CP 队列中排除。第二组由 25 例因怀疑胰腺恶性肿瘤而行手术治疗且最终病理诊断为 PC 的患者组成。测量并比较了这两组患者的 P-suPAR 水平。
尽管发生了 CP，但 P-suPAR 在随访期间仍保持低水平。PC 患者的 P-suPAR 明显高于 CP 患者[中位数 3.7（IQR 3.1-4.4）ng/mL]；=0.014。ROC 曲线的截断值为 2.8ng/mL，曲线下面积（AUC）为 0.79（95%CI 0.61-0.97），=0.009，用于区分 PC 和 CP 的敏感性和特异性分别为 88%和 70%。
PC 患者的 P-suPAR 高于 CP 患者，因此可用于区分 PC 和 CP。
