Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland.
Department of General and Bariatric Surgery and Emergency Medicine in Zabrze, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland.
Clin Hemorheol Microcirc. 2024;86(3):383-393. doi: 10.3233/CH-231987.
Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy with a low 5-year survival rate. Biomarkers may be of value for the early diagnosis of pancreatic cancer. This study assessed blood- and tumour tissue-based biomarkers associated with pancreatic cancer.
We studied 61 patients who underwent pancreatic resection. Of these 61 patients, 46 patients had PDAC, and 15 patients had inflammatory tumours. Blood and tumour tissue levels of VEGF, hypoxia-inducible factor 1α (HIF-1α) and glucose transporter 1 (GLUT1) were measured.
Blood concentrations of VEGF (p < 0.000001) and HIF-1α (p = 0.000002) were significantly higher in the PDAC group than in the inflammatory tumour group. Tumour tissue concentrations of VEGF (p < 0.000001), HIF-1α (p = 0.000005) and GLUT1 (0.000002) were also significantly higher in the PDAC group. Univariate analyses revealed that age, BMI, and blood levels of CA19-9, VEGF, and HIF-1α were potential predictors of PDAC. Potential predictors of PDAC in tumour tissue were VEGF, HIF-1α and GLUT1. Multivariate analyses found that VEGF was the most powerful independent predictor of PDAC in blood (OR = 1.016; 95% CI: 1.007-1.025; 0.001) and tumour tissue (OR = 1.02; 95% CI: 1.008-1.032, p = 0.001). The cut-off point for blood VEGF was 134.56 pg/ml, with a sensitivity of 97.8%, specificity of 86.7%, PPV of 95.7%, and NPV of 92.9%. The cut-off point for tissue tumour VEGF in PDAC was 208.59 pg/mg, with a sensitivity, specificity, PPV and NPV of 97.7%, 92.9%, 97.7%, and 92.9%, respectively.
There are significant differences in blood-based biomarkers for differentiating between PDAC and inflammatory tumours of the pancreas. VEGF was an independent predictor of PDAC independent of its addition to the routinely used tumour marker CA19-9 antigen.
胰腺导管腺癌（PDAC）是一种侵袭性很强的恶性肿瘤，5 年生存率很低。生物标志物可能对胰腺癌的早期诊断有价值。本研究评估了与胰腺癌相关的血液和肿瘤组织生物标志物。
我们研究了 61 例接受胰腺切除术的患者。其中 46 例为 PDAC 患者，15 例为炎症性肿瘤患者。测量了血液和肿瘤组织中血管内皮生长因子（VEGF）、缺氧诱导因子 1α（HIF-1α）和葡萄糖转运蛋白 1（GLUT1）的水平。
PDAC 组的血液 VEGF（p<0.000001）和 HIF-1α（p=0.000002）浓度明显高于炎症性肿瘤组。PDAC 组肿瘤组织中 VEGF（p<0.000001）、HIF-1α（p=0.000005）和 GLUT1（0.000002）浓度也明显升高。单因素分析显示，年龄、BMI 以及 CA19-9、VEGF 和 HIF-1α 的血液水平是 PDAC 的潜在预测因子。肿瘤组织中 PDAC 的潜在预测因子为 VEGF、HIF-1α 和 GLUT1。多因素分析发现，VEGF 是血液（OR=1.016；95%CI：1.007-1.025；0.001）和肿瘤组织（OR=1.02；95%CI：1.008-1.032，p=0.001）中 PDAC 最强的独立预测因子。血液 VEGF 的截断值为 134.56 pg/ml，其敏感性为 97.8%，特异性为 86.7%，PPV 为 95.7%，NPV 为 92.9%。PDAC 中肿瘤组织 VEGF 的截断值为 208.59 pg/mg，其敏感性、特异性、PPV 和 NPV 分别为 97.7%、92.9%、97.7%和 92.9%。
区分 PDAC 和胰腺炎症性肿瘤的血液生物标志物存在显著差异。VEGF 是 PDAC 的独立预测因子，独立于其与常规肿瘤标志物 CA19-9 抗原联合应用。
