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CA19-9 and apolipoprotein-A2 isoforms as detection markers for pancreatic cancer : a prospective evaluation

Honda, Kazufumi; Katzke, Verena A.; Hüsing, Anika; Okaya, Shinobu; Shoji, Hirokazu; Onidani, Kaoru; Olsen, Anja; Tjønneland, Anne; Overvad, Kim and Weiderpass, Elisabete, et al. (2018) In International Journal of Cancer
Abstract

Recently, we identified unique processing patterns of apolipoprotein A2 (ApoA2) in patients with pancreatic cancer. Our study provides a first prospective evaluation of an ApoA2 isoform (“ApoA2-ATQ/AT”), alone and in combination with carbohydrate antigen 19–9 (CA19-9), as an early detection biomarker for pancreatic cancer. We performed ELISA measurements of CA19-9 and ApoA2-ATQ/AT in 156 patients with pancreatic cancer and 217 matched controls within the European EPIC cohort, using plasma samples collected up to 60 months prior to diagnosis. The detection discrimination statistics were calculated for risk scores by strata of lag-time. For CA19-9, in univariate marker analyses, C-statistics to distinguish future pancreatic cancer... (More)

Recently, we identified unique processing patterns of apolipoprotein A2 (ApoA2) in patients with pancreatic cancer. Our study provides a first prospective evaluation of an ApoA2 isoform (“ApoA2-ATQ/AT”), alone and in combination with carbohydrate antigen 19–9 (CA19-9), as an early detection biomarker for pancreatic cancer. We performed ELISA measurements of CA19-9 and ApoA2-ATQ/AT in 156 patients with pancreatic cancer and 217 matched controls within the European EPIC cohort, using plasma samples collected up to 60 months prior to diagnosis. The detection discrimination statistics were calculated for risk scores by strata of lag-time. For CA19-9, in univariate marker analyses, C-statistics to distinguish future pancreatic cancer patients from cancer-free individuals were 0.80 for plasma taken ≤6 months before diagnosis, and 0.71 for >6–18 months; for ApoA2-ATQ/AT, C-statistics were 0.62, and 0.65, respectively. Joint models based on ApoA2-ATQ/AT plus CA19-9 significantly improved discrimination within >6–18 months (C = 0.74 vs. 0.71 for CA19-9 alone, p = 0.022) and ≤ 18 months (C = 0.75 vs. 0.74, p = 0.022). At 98% specificity, and for lag times of ≤6, >6–18 or ≤ 18 months, sensitivities were 57%, 36% and 43% for CA19-9 combined with ApoA2-ATQ/AT, respectively, vs. 50%, 29% and 36% for CA19-9 alone. Compared to CA19-9 alone, the combination of CA19-9 and ApoA2-ATQ/AT may improve detection of pancreatic cancer up to 18 months prior to diagnosis under usual care, and may provide a useful first measure for pancreatic cancer detection prior to imaging.

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keywords
apolipoprotein A2, CA19-9, early detection, isoforms, pancreatic cancer, prospective study
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International Journal of Cancer
publisher
John Wiley & Sons
external identifiers
  • scopus:85058028091
ISSN
0020-7136
DOI
10.1002/ijc.31900
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English
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yes
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32f591ca-5659-498a-8f1a-fe00e159e909
date added to LUP
2019-01-08 15:28:15
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2019-02-20 11:42:10
@article{32f591ca-5659-498a-8f1a-fe00e159e909,
  abstract     = {<p>Recently, we identified unique processing patterns of apolipoprotein A2 (ApoA2) in patients with pancreatic cancer. Our study provides a first prospective evaluation of an ApoA2 isoform (“ApoA2-ATQ/AT”), alone and in combination with carbohydrate antigen 19–9 (CA19-9), as an early detection biomarker for pancreatic cancer. We performed ELISA measurements of CA19-9 and ApoA2-ATQ/AT in 156 patients with pancreatic cancer and 217 matched controls within the European EPIC cohort, using plasma samples collected up to 60 months prior to diagnosis. The detection discrimination statistics were calculated for risk scores by strata of lag-time. For CA19-9, in univariate marker analyses, C-statistics to distinguish future pancreatic cancer patients from cancer-free individuals were 0.80 for plasma taken ≤6 months before diagnosis, and 0.71 for &gt;6–18 months; for ApoA2-ATQ/AT, C-statistics were 0.62, and 0.65, respectively. Joint models based on ApoA2-ATQ/AT plus CA19-9 significantly improved discrimination within &gt;6–18 months (C = 0.74 vs. 0.71 for CA19-9 alone, p = 0.022) and ≤ 18 months (C = 0.75 vs. 0.74, p = 0.022). At 98% specificity, and for lag times of ≤6, &gt;6–18 or ≤ 18 months, sensitivities were 57%, 36% and 43% for CA19-9 combined with ApoA2-ATQ/AT, respectively, vs. 50%, 29% and 36% for CA19-9 alone. Compared to CA19-9 alone, the combination of CA19-9 and ApoA2-ATQ/AT may improve detection of pancreatic cancer up to 18 months prior to diagnosis under usual care, and may provide a useful first measure for pancreatic cancer detection prior to imaging.</p>},
  author       = {Honda, Kazufumi and Katzke, Verena A. and Hüsing, Anika and Okaya, Shinobu and Shoji, Hirokazu and Onidani, Kaoru and Olsen, Anja and Tjønneland, Anne and Overvad, Kim and Weiderpass, Elisabete and Vineis, Paolo and Muller, David and Tsilidis, Kostas and Palli, Domenico and Pala, Valeria and Tumino, Rosario and Naccarati, Alessio and Panico, Salvatore and Aleksandrova, Krasimira and Boeing, Heiner and Bueno-de-Mesquita, H. Bas and Peeters, Petra H. and Trichopoulou, Antonia and Lagiou, Pagona and Khaw, Kay Tee and Wareham, Nick and Travis, Ruth C. and Merino, Susana and Duell, Eric J. and Rodríguez-Barranco, Miguel and Chirlaque, María Dolores and Barricarte, Aurelio and Rebours, Vinciane and Boutron-Ruault, Marie Chiristine and Romana Mancini, Francesca and Brennan, Paul and Scelo, Ghislaine and Manjer, Jonas and Sund, Malin and Öhlund, Daniel and Canzian, Federico and Kaaks, Rudolf},
  issn         = {0020-7136},
  keyword      = {apolipoprotein A2,CA19-9,early detection,isoforms,pancreatic cancer,prospective study},
  language     = {eng},
  month        = {01},
  publisher    = {John Wiley & Sons},
  series       = {International Journal of Cancer},
  title        = {CA19-9 and apolipoprotein-A2 isoforms as detection markers for pancreatic cancer : a prospective evaluation},
  url          = {http://dx.doi.org/10.1002/ijc.31900},
  year         = {2018},
}