(HealthDay News) — Fecal microbiota-based screening seems feasible for early detection of pancreatic ductal adenocarcinoma (PDAC), according to a study published online March 8 in Gut.

Ece Kartal, Ph.D., from the European Molecular Biology Laboratory in Heidelberg, Germany, and colleagues applied shotgun metagenomic and 16S rRNA amplicon sequencing to samples from a Spanish case-control study with 57 cases, 50 controls, and 29 patients with chronic pancreatitis in the discovery phase and from a Germany case-control study with 76 participants in the validation phase. Fecal and salivary microbiota were explored as potential diagnostic biomarkers.

The researchers found that compared with salivary-based classifiers, fecal metagenomic classifiers performed much better, identifying PDAC patients with an accuracy of up to 0.84 area under the receiver operating characteristic curve (AUROC) based on a set of 27 microbial species. Accuracy was consistent across early and late disease stages.


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When microbiome-based predictions were combined with serum levels of carbohydrate antigen 19-9, performance further improved up to 0.94 AUROC. When validated against 25 publicly available metagenomic study populations for distinct health conditions, a microbiota-based classification model confined to PDAC-enriched species was highly disease-specific.

In the validation population, both microbiome-based models had high prediction accuracy. Using 16S rRNA sequencing and fluorescence in situ hybridization, several fecal PDAC marker species were detectable in pancreatic tumor and nontumor tissue.

“The described fecal microbiome signatures enabled robust metagenomic classifiers for PDAC detection at high disease specificity, complementary to existing markers, and with potential towards cost-effective PDAC screening and monitoring,” the authors write.

Several authors have a pending patent application of early detection of pancreatic cancer based on microbial markers.

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