外泌体糖蛋白聚糖-1可区分胰腺导管腺癌和慢性胰腺炎。

Exosomal glypican-1 discriminates pancreatic ductal adenocarcinoma from chronic pancreatitis.

机构信息

Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal; Medical Faculty of the University of Porto, Porto, Portugal.

Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal; Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal; Instituto de Ciências Biomédicas Abel Salazar (ICBAS), University of Porto, Porto, Portugal.

出版信息

Dig Liver Dis. 2022 Jul;54(7):871-877. doi: 10.1016/j.dld.2021.10.012. Epub 2021 Nov 25.

DOI:10.1016/j.dld.2021.10.012

PMID:34840127

Abstract

BACKGROUND AND AIMS

Pancreatic ductal adenocarcinoma (PDAC) diagnosis can be difficult in a chronic pancreatitis (CP) background, especially in its mass forming presentation. We aimed to assess the accuracy of glypican-1-positive circulating exosomes (GPC1crExos) to distinguish PDAC from CP versus the state-of-the-art CA 19-9 biomarker.

METHODS

This was a unicentric prospective cohort. Endoscopic ultrasound with fine-needle aspiration or biopsy and blood tests (GPC1crExos and serum CA 19-9) were performed.

RESULTS

The cohort comprised 60 PDAC and 29 CP (7 of which mass forming - MF) patients. Median levels of GPC1crExos were significantly higher in PDAC (99.7%) versus CP (28.4%; p<0.0001) with an AUROC of 0.96 with 98.3% sensitivity and 86.2% specificity for a cut-off of 45.0% (p<0.0001); this outperforms CA 19-9 AUROC of 0.82 with 78.3% sensitivity and 65.5% specificity at a cut-off of 37 U/mL (p<0.0001). The superiority of% GPC1+crExos over CA 19-99 in differentiating PDAC from CP was observed in both early (stage I) and advanced tumors (stages II-IV).

CONCLUSION

Levels of GPC1crExos coupled to beads enable differential diagnosis between PDAC and CP including its mass-forming presentation.

摘要

背景和目的

在慢性胰腺炎（CP）背景下，胰腺导管腺癌（PDAC）的诊断可能具有挑战性，尤其是在其肿块形成的表现中。我们旨在评估 GPC1 阳性循环外泌体（GPC1crExos）区分 PDAC 与 CP 的准确性，与最先进的 CA 19-9 生物标志物相比。

方法

这是一项单中心前瞻性队列研究。进行了内镜超声检查，包括细针抽吸或活检以及血液检查（GPC1crExos 和血清 CA 19-9）。

结果

该队列包括 60 名 PDAC 和 29 名 CP（其中 7 名为肿块形成-MF）患者。PDAC 患者的 GPC1crExos 中位数水平明显高于 CP（99.7%对 28.4%；p<0.0001），AUROC 为 0.96，截断值为 45.0%时，敏感性为 98.3%，特异性为 86.2%（p<0.0001）；这优于 CA 19-9 的 AUROC 为 0.82，截断值为 37 U/mL 时，敏感性为 78.3%，特异性为 65.5%（p<0.0001）。在早期（I 期）和晚期肿瘤（II-IV 期）中，%GPC1+crExos 区分 PDAC 与 CP 的优势均优于 CA 19-9。