Cited by 87Pancreatic and Hepatic Oncology ResearchPancreatitis Pathology and TreatmentCholangiocarcinoma and Gallbladder Cancer Studies

Decreased serum thrombospondin-1 levels in pancreatic cancer patients up to 24 months prior to clinical diagnosis: association with diabetes mellitus

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Jenkinson, Claire, Elliott, Victoria L., Evans, Anthony, Oldfield, Lucy, Jenkins, Rosalind E., O'Brien, Darragh P., Apostolidou, Sophia, Gentry-Maharaj, Aleksandra +13 more·2016·Clinical Cancer Research

Published version of a preprint

Abstract

PURPOSE: Identification of serum biomarkers enabling earlier diagnosis of pancreatic ductal adenocarcinoma (PDAC) could improve outcome. Serum protein profiles in patients with preclinical disease and at diagnosis were investigated. EXPERIMENTAL DESIGN: Serum from cases up to 4 years prior to PDAC diagnosis and controls (UKCTOCS,n= 174) were studied, alongside samples from patients diagnosed with PDAC, chronic pancreatitis, benign biliary disease, type 2 diabetes mellitus, and healthy subjects (n= 298). Isobaric tags for relative and absolute quantification (iTRAQ) enabled comparisons of pooled serum from a test set (n= 150). Validation was undertaken using multiple reaction monitoring (MRM) and/or Western blotting in all 472 human samples and samples from a KPC mouse model. RESULTS: iTRAQ identified thrombospondin-1 (TSP-1) as reduced preclinically and in diagnosed samples. MRM confirmed significant reduction in levels of TSP-1 up to 24 months prior to diagnosis. A combination of TSP-1 and CA19-9 gave an AUC of 0.86, significantly outperforming both markers alone (0.69 and 0.77, respectively;P< 0.01). TSP-1 was also decreased in PDAC patients compared with healthy controls (P< 0.05) and patients with benign biliary obstruction (P< 0.01). Low levels of TSP-1 correlated with poorer survival, preclinically (P< 0.05) and at clinical diagnosis (P< 0.02). In PDAC patients, reduced TSP-1 levels were more frequently observed in those with confirmed diabetes mellitus (P< 0.01). Significantly lower levels were also observed in PDAC patients with diabetes compared with individuals with type 2 diabetes mellitus (P= 0.01). CONCLUSIONS: Circulating TSP-1 levels decrease up to 24 months prior to diagnosis of PDAC and significantly enhance the diagnostic performance of CA19-9. The influence of diabetes mellitus on biomarker behavior should be considered in future studies.

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Authors
Jenkinson, C., Elliott, V. L., Evans, A., Oldfield, L., Jenkins, R. E., O'Brien, D. P., Apostolidou, S., Gentry-Maharaj, A., Fourkala, E.-O., Jacobs, I. J., Menon, U., Cox, T., Campbell, F., Pereira, S. P., Tuveson, D. A., Park, B. K., Greenhalf, W., Sutton, R., Timms, J. F., Neoptolemos, J. P., & Costello, E.
Affiliations
  • University of Liverpool (GB)
  • University College London (GB)
  • 4Department of Women's Cancer, Institute for Women's Health, University College London, United Kingdom.
  • University of Manchester (GB)
  • Cold Spring Harbor Laboratory (US)
Corresponding author
Costello, Eithne
Venue
Clinical Cancer Research
Published
2016-03-31
Volume
22
Issue
7
Pages
1734-1743
ISSN
  • 1078-0432 (ISSN-L)
  • 1557-3265
OpenAlex
W2173639106
Cited by
87
References
33
Citations by year
2026: 1 · 2025: 10 · 2024: 5 · 2023: 2 · 2022: 7 · 2021: 11 · 2020: 14 · 2019: 4 · 2018: 14 · 2017: 13 · 2016: 6
FWCI
4.80
Type
journal article
Language
en
Open access
Locations
  • Clinical Cancer Research (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • Cold Spring Harbor Laboratory Institutional Repository (Cold Spring Harbor Laboratory) (submittedVersion)
Funders
Northwest Cancer Research Fund, UK, grant CR976, The National Institute for Health Research Pancreas Biomedical Research Unit, Cancer Research UK (FP7/2007-2013)
Topics
  • Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
  • Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
  • Health Sciences › Medicine › Surgery › Cholangiocarcinoma and Gallbladder Cancer Studies
Keywords
thrombospondin-1, pancreatic ductal adenocarcinoma, early diagnosis, serum biomarkers, CA19-9, type 2 diabetes, preclinical disease, survival, chronic pancreatitis, benign biliary obstruction, KPC mouse model
MeSH terms
Aged, Animals, Diabetes Mellitus, Type 2, Disease Models, Animal, Female, Humans, Male, Middle Aged, Neoplasm Staging, Pancreatic Neoplasms, Platelet Count, Time Factors, Biomarkers, Tumor, Reproducibility of Results, Case-Control Studies, Thrombospondin 1, Carcinoma, Pancreatic Ductal, Proteomics, Mice, Early Detection of Cancer, Patient Outcome Assessment

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