Blood-based Migration Signature Biomarker Panel Discriminates Early Stage New Onset Diabetes related Pancreatic Ductal Adenocarcinoma from Type 2 Diabetes

Seetharaman Balasenthil; Suyu Liu; Jianliang Dai; William R Bamlet; Gloria Petersen; Suresh T Chari; Anirban Maitra; Nanyue Chen; Subrata Sen; Ann McNeill Killary

doi:10.1016/j.cca.2023.117567

Blood-based Migration Signature Biomarker Panel Discriminates Early Stage New Onset Diabetes related Pancreatic Ductal Adenocarcinoma from Type 2 Diabetes

Clin Chim Acta. 2023 Nov 1:551:117567. doi: 10.1016/j.cca.2023.117567. Epub 2023 Sep 27.

Authors

Affiliations

¹ Department of Translational Molecular Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
² Department of Biostatistics, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
³ Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA.
⁴ Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA.
⁵ Department of Gastroenterology, Hepatology, and Nutrition, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
⁶ Department of Translational Molecular Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA; Sheikh Ahmed Center for Pancreatic Cancer Research, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA.
⁷ Department of Translational Molecular Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA. Electronic address: akillary@mdanderson.org.

PMID: 37774897
DOI: 10.1016/j.cca.2023.117567

Abstract

Background and aims: While type 2 diabetes is a well-known risk factor for pancreatic ductal adenocarcinoma (PDAC), PDAC-induced new-onset diabetes (PDAC-NOD) is a manifestation of underlying PDAC. In this study, we sought to identify potential blood-based biomarkers for distinguishing PDAC-NOD from type 2 diabetes (T2DM) without PDAC.

Materials and methods: By ELISA analysis, a migration signature biomarker panel comprising tissue factor pathway inhibitor (TFPI), tenascin C (TNC-FNIII-C) and CA 19-9 was analyzed in plasma samples from 50 PDAC-NOD and 50 T2DM controls.

Results: Both TFPI (area under the curve (AUC) 0.71) and TNC-FNIII-C (AUC 0.69) outperformed CA 19-9 (AUC 0.60) in distinguishing all stages of PDAC-NOD from T2DM controls. The combined panel showed an AUC of 0.82 (95% CI = 0.73-0.90) (p = 0.002). In the PDAC-NOD early stage II samples, the three biomarkers had an AUC of 0.84 (95% CI = 0.73-0.93) vs CA 19-9, AUC = 0.60, (95% CI = 0.45-0.73), which also improved significance (p = 0.0123).

Conclusion: The migration signature panel adds significantly to CA 19-9 to discriminate PDAC-NOD from T2DM controls and warrants further validation for high-risk group stratification.

Keywords: Biomarkers; Blinded Validation; Diabetes; Early Detection; Pancreatic Cancer.

MeSH terms

Biomarkers, Tumor
CA-19-9 Antigen
Carcinoma, Pancreatic Ductal* / diagnosis
Diabetes Mellitus, Type 2* / diagnosis
Humans
Pancreatic Neoplasms*

Substances

Biomarkers, Tumor
CA-19-9 Antigen