Saeed Baraa Ahmed, Faisal Anwer Jaber, Mahmood Bassam Shaker, Thanoon Allaa Hatim
Ibn Sina University of Medical and Pharmaceutical Sciences, Baghdad, Iraq.
Iraqi Center for Cancer and Medical Genetic Research, Mustansiriyah University, Baghdad, Iraq.
Asian Pac J Cancer Prev. 2024 Dec 1;25(12):4407-4414. doi: 10.31557/APJCP.2024.25.12.4407.
Pancreatic cancer exhibits a high level of aggressiveness and is associated with a high mortality rate. The study comprised 50 patients with pancreatic cancer and 50 healthy family members and friends. The main goal is to explore the biomarkers carbohydrate antigen 19-9 (CA19-9), amylase, procalcitonin (PCT), and interleukin 6 (IL-6), confirm the presence of Escherichia coli infection in the patients' bloodstreams, and evaluate the effect of chronic inflammation on the progression of pancreatic cancer.
The CA19-9, IL-6, and PCT levels of the control and patient groups were measured with Roche-Cobas C411, and their amylase levels were measured with Cobas C311. In addition, a VITEK2 Compact system was utilized to detect E. coli blood infection, and the antibiotic susceptibility of the patients was evaluated.
The higher PCT and IL-6 levels (P < 0.0001*) of the patients with pancreatic cancer indicated chronic inflammation promoting tumor growth, invasion, and metastasis, and high levels of CA19-9 (P < 0.0001*) indicated pancreatic cancer. Moreover, tumor damage and ductal blockage lowered amylase levels in patients with pancreatic cancer. In addition, bloodstream infections in patients with pancreatic cancer were mostly caused by E. coli (34/50, 68%), and the isolates were resistant to ciprofloxacin (100%). Approximately, 94.11% were resistant to levofloxacin and ceftazidime, whereas only 26.4% were resistant to sulfamethoxazole/ trimethoprim. A total of 29 isolates (85.2%) were multidrug resistant.
Chronic inflammation from E. coli infections is crucial to pancreatic cancer progression. Inflammatory indicators, including PCT and IL-6, and diagnostic biomarkers, including CA19-9 and amylase, reveal malignancy growth and bacterial infections that complicate treatment. Patients with positive PCT and IL-6 results were likely to have positive blood cultures and E. coli infections. These biomarkers should be utilized alongside other diagnostic imaging and biopsy methods to improve the detection of pancreatic cancer and screening for bacterial infections.
胰腺癌具有高度侵袭性，死亡率高。该研究纳入了50例胰腺癌患者以及50名健康的家庭成员和朋友。主要目的是探索生物标志物糖类抗原19-9（CA19-9）、淀粉酶、降钙素原（PCT）和白细胞介素6（IL-6），确认患者血流中是否存在大肠杆菌感染，并评估慢性炎症对胰腺癌进展的影响。
使用罗氏Cobas C411测定对照组和患者组的CA19-9、IL-6和PCT水平，使用Cobas C311测定淀粉酶水平。此外，利用VITEK2 Compact系统检测大肠杆菌血液感染情况，并评估患者的抗生素敏感性。
胰腺癌患者较高的PCT和IL-6水平（P < 0.0001*）表明慢性炎症促进肿瘤生长、侵袭和转移，而高水平的CA19-9（P < 0.0001*）表明患有胰腺癌。此外，肿瘤损伤和导管阻塞降低了胰腺癌患者的淀粉酶水平。另外，胰腺癌患者的血流感染大多由大肠杆菌引起（34/50，68%），分离株对环丙沙星耐药（100%）。约94.11%对左氧氟沙星和头孢他啶耐药，而仅26.4%对磺胺甲恶唑/甲氧苄啶耐药。共有29株分离株（85.2%）多重耐药。
大肠杆菌感染引起的慢性炎症对胰腺癌进展至关重要。包括PCT和IL-6在内的炎症指标以及包括CA19-9和淀粉酶在内的诊断生物标志物揭示了恶性肿瘤生长和使治疗复杂化的细菌感染。PCT和IL-6结果呈阳性的患者可能血培养呈阳性且存在大肠杆菌感染。这些生物标志物应与其他诊断性影像学和活检方法一起使用，以提高胰腺癌的检测和细菌感染的筛查。
