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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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
- ORCID
- Venue
- Clinical Cancer Research
- Published
- 2016-03-31
- Volume
- 22
- Issue
- 7
- Pages
- 1734-1743
- ISSN
- 1078-0432 (ISSN-L)
- 1557-3265
- PMC
- PMC4820087
- 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
- green
- www.ncbi.nlm.nih.gov
- 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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