Early Detection and Diagnosis of Pancreatic Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Biomarkers".

Deadline for manuscript submissions: closed (30 September 2022)

Special Issue Information

Dear Colleagues,

Pancreatic ductal adenocarcinoma (PDAC) is a leading cause of cancer deaths in Western countries and one of the most lethal of the common cancers. The disease is almost always detected at an advanced stage. This makes curative interventions difficult and contributes to the extremely poor 5-year survival rate of 3% to 15%. The late detection of PDAC can be attributed to a number of factors, including complex underlying biology, vague symptoms which overlap with a variety of benign diseases, a lack of biomarkers that are validated for early detection, and the absence of imaging techniques that can detect precancerous lesions with accuracy. While screening is recommended in high-risk groups, the fact that PDAC is relatively uncommon and that accurate detection tests are not available means that screening of asymptomatic individuals in the general population is not feasible.

It is recognized that early cancer detection reduces mortality, and currently, there is a wave of interest in finding ways to detect PDAC earlier. This Special Issue will highlight recent progress with regard to high-risk groups, biomarker development, as well as advances in imaging and prediction modeling.

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Keywords

  • pancreatic cancer
  • biomarkers
  • early detection
  • PanIN
  • artificial intelligence
  • imaging
  • IPMN
  • cystic lesion
  • type 3c diabetes

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Published Papers (3 papers)

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Research

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18 pages, 3248 KiB  
Article
Cytokines and Lymphoid Populations as Potential Biomarkers in Locally and Borderline Pancreatic Adenocarcinoma
by Iranzu González-Borja, Antonio Viúdez, Emilia Alors-Pérez, Saioa Goñi, Irene Amat, Ismael Ghanem, Roberto Pazo-Cid, Jaime Feliu, Laura Alonso, Carlos López, Virginia Arrazubi, Javier Gallego, Jairo Pérez-Sanz, Irene Hernández-García, Ruth Vera, Justo P Castaño and Joaquín Fernández-Irigoyen
Cancers 2022, 14(23), 5993; https://doi.org/10.3390/cancers14235993 - 5 Dec 2022
Cited by 3 | Viewed by 2192
Abstract
Despite its relative low incidence, PDAC is one of the most aggressive and lethal types of cancer, being currently the seventh leading cause of cancer death worldwide, with a 5-year survival rate of 10.8%. Taking into consideration the necessity to improve the prognosis [...] Read more.
Despite its relative low incidence, PDAC is one of the most aggressive and lethal types of cancer, being currently the seventh leading cause of cancer death worldwide, with a 5-year survival rate of 10.8%. Taking into consideration the necessity to improve the prognosis of these patients, this research has been focused on the discovery of new biomarkers. For this purpose, patients with BL and resectable disease were recruited. Serum cytokines and growth factors were monitored at different time points using protein arrays. Immune cell populations were determined by flow cytometry in peripheral blood as well as by immunohistochemistry (IHC) in tumor tissues. Several cytokines were found to be differentially expressed between the study subgroups. In the BL disease setting, two different scores were proven to be independent prognostic factors for progression-free survival (PFS) (based on IL-10, MDC, MIF, and eotaxin-3) and OS (based on eotaxin-3, NT-3, FGF-9, and IP10). In the same context, CA19-9 was found to play a role as independent prognostic factor for OS. Eotaxin-3 and MDC cytokines for PFS, and eotaxin-3, NT-3, and CKβ8-1 for OS, were shown to be predictive biomarkers for nab-paclitaxel and gemcitabine regimen. Similarly, oncostatin, BDNF, and IP10 cytokines were proven to act as predictive biomarkers regarding PFS, for FOLFIRINOX regimen. In the resectable cohort, RANTES, TIMP-1, FGF-4, and IL-10 individually differentiated patients according to their cancer-associated survival. Regarding immune cell populations, baseline high levels of circulating B lymphocytes were related to a significantly longer OS, while these levels significantly decreased as progression occurred. Similarly, baseline high levels of helper lymphocytes (CD4+), low levels of cytotoxic lymphocytes (CD8+), and a high CD4/CD8 ratio, were related to a significantly longer PFS. Finally, high levels of CD4+ and CD8+ intratumoural infiltration was associated with significantly longer PFS. In conclusion, in this study we were able to identify several prognostic and predictive biomarker candidates in patients diagnosed of resectable or BL PDAC. Full article
(This article belongs to the Special Issue Early Detection and Diagnosis of Pancreatic Cancer)
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10 pages, 1177 KiB  
Article
Circulating Tissue Polypeptide-Specific Antigen in Pre-Diagnostic Pancreatic Cancer Samples
by Emmy Borgmästars, Erik Lundberg, Daniel Öhlund, Hanna Nyström, Oskar Franklin, Christina Lundin, Pär Jonsson and Malin Sund
Cancers 2021, 13(21), 5321; https://doi.org/10.3390/cancers13215321 - 23 Oct 2021
Cited by 5 | Viewed by 2254
Abstract
Early detection of pancreatic ductal adenocarcinoma (PDAC) is challenging, and late diagnosis partly explains the low 5-year survival. Novel and sensitive biomarkers are needed to enable early PDAC detection and improve patient outcomes. Tissue polypeptide specific antigen (TPS) has been studied as a [...] Read more.
Early detection of pancreatic ductal adenocarcinoma (PDAC) is challenging, and late diagnosis partly explains the low 5-year survival. Novel and sensitive biomarkers are needed to enable early PDAC detection and improve patient outcomes. Tissue polypeptide specific antigen (TPS) has been studied as a biomarker in PDAC diagnostics, and it has previously been shown to reflect clinical status better than the ‘golden standard’ biomarker carbohydrate antigen 19-9 (CA 19-9) that is most widely used in the clinical setting. In this cross-sectional case-control study using pre-diagnostic plasma samples, we aim to evaluate the potential of TPS as a biomarker for early PDAC detection. Furthermore, in a subset of individuals with multiple samples available at different time points before diagnosis, a longitudinal analysis was used. We assessed plasma TPS levels using enzyme-linked immunosorbent assay (ELISA) in 267 pre-diagnostic PDAC plasma samples taken up to 18.8 years before clinical PDAC diagnosis and in 320 matched healthy controls. TPS levels were also assessed in 25 samples at PDAC diagnosis. Circulating TPS levels were low both in pre-diagnostic samples of future PDAC patients and in healthy controls, whereas TPS levels at PDAC diagnosis were significantly increased (odds ratio 1.03; 95% confidence interval: 1.01–1.05) in a logistic regression model adjusted for age. In conclusion, TPS levels increase late in PDAC progression and hold no potential as a biomarker for early detection. Full article
(This article belongs to the Special Issue Early Detection and Diagnosis of Pancreatic Cancer)
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Review

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15 pages, 1234 KiB  
Review
The Role of Positron Emission Tomography/Computed Tomography (PET/CT) for Staging and Disease Response Assessment in Localized and Locally Advanced Pancreatic Cancer
by Michele Ghidini, Marta Vuozzo, Barbara Galassi, Paola Mapelli, Virginia Ceccarossi, Lucio Caccamo, Maria Picchio and Daniele Dondossola
Cancers 2021, 13(16), 4155; https://doi.org/10.3390/cancers13164155 - 18 Aug 2021
Cited by 13 | Viewed by 3573
Abstract
Pancreatic Cancer (PC) has a poor prognosis, with a 5-year survival rate of only 9%. Even after radical surgical procedures, PC patients have poor survival rates, with a high chance of relapse (70–80%). Imaging is involved in all aspects of the clinical management [...] Read more.
Pancreatic Cancer (PC) has a poor prognosis, with a 5-year survival rate of only 9%. Even after radical surgical procedures, PC patients have poor survival rates, with a high chance of relapse (70–80%). Imaging is involved in all aspects of the clinical management of PC, including detection and characterization of primary tumors and their resectability, assessment of vascular, perineural and lymphatic invasion and detection of distant metastases. The role of Positron Emission Tomography/Computed Tomography (PET/CT) in detecting PC is still controversial, with the international guidelines not recommending its routine use. However, in resectable PC, PET/CT may play a role in assessing PC stage and grade and potential resectability after neoadjuvant treatment. Quantitative image analysis (radiomics) and new PET/CT radiotracers account for future developments in metabolic imaging and may further improve the relevance of this technique in several aspects of PC. In the present review, the current state of the art and future directions of PET/CT in resectable PC are presented. Full article
(This article belongs to the Special Issue Early Detection and Diagnosis of Pancreatic Cancer)
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