Proteomic Analysis Yields Urine Test for Early Diagnosis of Pancreatic Cancer

A research team at the Barts Cancer Institute in London has identified a 3-protein molecular signature in pancreatic cancer patients of both genders, but not in healthy individuals. While individuals with pancreatitis are known to have a similar molecular and pathological profile as those with pancreatic cancer, expression of the 3 proteins identified by the study was much lower in those stricken with pancreatitis.

Pancreatic cancer is the 4^th leading cause of cancer-related deaths in the United States among both men and women, with over 40,000 deaths estimated in 2015. Importantly, 72% of patients dies within the first year of diagnosis. Lack of clinical symptoms make pancreatic cancer a very difficult disease to treat; diagnosis is usually late, after the disease has metastasized and is much harder to treat. At that stage, patients are ineligible for surgery as well—currently the only “curative” treatment for PDAC. Early detection tools can significantly impact these dismal statistics.

A total of 488 urine samples were analyzed in this study published in Clinical Cancer Research—192 from pancreatic ductal adenocarcinoma (PDAC) patients, 92 from chronic pancreatitis patients, and 87 from healthy individuals. Additional validation was conducted with 117 samples from patients with benign and malignant liver and gall bladder conditions. Of the 1500 proteins that were identified in the total population, 3 proteins: LYVE1, REG1A, and TFF1 were identified as lead candidates for further evaluation. Statistical analysis of the GeLC/MS/MS data showed that patients with pancreatic cancer have increased levels of these 3 proteins compared with urine samples from healthy patients, while patients with chronic pancreatitis had significantly lower levels than cancer patients. The authors believe that the 3 protein panel can detect patients with early stage (I-II) PDAC with more than 90% accuracy.

“We've always been keen to develop a diagnostic test in urine as it has several advantages over using blood. It's an inert and far less complex fluid than blood and can be repeatedly and non-invasively tested,” said Tatjana Crnogorac-Jurcevic, MD, PhD, lead author on the study, in a statement. This is a biomarker panel with good specificity and sensitivity and we're hopeful that a simple, inexpensive test can be developed and be in clinical use within the next few years."

Further studies will validate the findings in individuals in the high-risk group. Additionally, Dr Crnogorac-Jurcevic is keen to study the expression of these 3 proteins during the latency period (time between genetic changes that initiate the cancer and the time of clinical presentation of disease) in individuals who went on to develop the cancer.