(HealthDay News) — Two diagnostic panels based on microRNA expression from whole blood can distinguish, to some degree, patients with pancreatic cancer from healthy controls, according to a study published in the Jan. 22/29 issue of the Journal of the American Medical Association.
Nicolai A. Schultz, MD, PhD, from Copenhagen University Hospital in Denmark, and colleagues describe differences in microRNA expression in whole blood between 409 patients with pancreatic cancer, 25 patients with chronic pancreatitis, and 312 blood donors as healthy participants. MicroRNA expressions in pretreatment whole blood RNA samples were assessed in a discovery cohort, training cohort, and validation cohort.
The researchers identified 38 microRNAs in whole blood in the discovery cohort that were significantly dysregulated in patients with pancreatic cancer versus controls. In the training cohort, diagnostic panels, comprising four microRNAs in index I and 10 microRNAs in index II, were assessed. The area under the curve (AUC), sensitivity, and specificity were 0.86, 0.85, and 0.64 for index I, and 0.93, 0.85, and 0.85 for index II in the training cohort, compared with 0.90, 0.86, and 0.99 for the cancer antigen 19-9 (CA19-9).
In the validation cohort, combining panels and CA19-9 resulted in strengthened performance, with an AUC of 0.94 for index I and CA19-9 and 0.93 for index II and CA19-9. The AUC for index I and CA19-9 was significantly higher than that for CA19-9 alone (P = 0.01). The AUC in patients with stage IA-IIB pancreatic cancer was 0.80, 0.83, 0.91, and 0.91 for index I, index I and CA19-9, index II, and index II and CA19-9, respectively.
“Further research is necessary to understand whether these have clinical implications for early detection of pancreatic cancer and how much this information adds to serum CA19-9,” the researchers wrote.
In an accompanying editorial, Donald J. Buchsbaum, PhD, of the University of Alabama, Birmingham, and Carlo M. Croce, MD, of Ohio State University, Columbus, also agreed that additional research is needed regarding the use of microRNAs for the early detection of pancreatic cancer.
“Even though the study was relatively large, well-conducted, and addressed the important topic of development of noninvasive methods to detect pancreatic cancer, the authors appropriately acknowledge the exploratory nature of the investigation,” they wrote.
“Given the dismal prognosis for patients with pancreatic cancer, it is important that new diagnostic approaches, such as the one used in this study, are sought. However, additional rigorous investigation will be necessary to support and extend these interesting findings.”
Several authors are named in a European patent application, which has been submitted by Copenhagen University Hospital.
- Schultz NA, Dehlendorff C, Jensen BV, et al. MicroRNA Biomarkers in Whole Blood for Detection of Pancreatic Cancer. JAMA. 2014;311(4):392-404.
- Buchsbaum DJ, Croce CM. ill Detection of MicroRNA Biomarkers in Blood Improve the Diagnosis and Survival of Patients With Pancreatic Cancer? JAMA. 2014;311(4):363-365.