Diagnosis of early pancreatic cancer and precursor lesions
Authors:
M. Hrůzová 1; B. Bunganič 1; J. Csomor 1; M. Zavoral 1; F. Bělina 2; L. Habartová 3; V. Setnička 3
Authors‘ workplace:
Interní klinika 1. LF Univerzity Karlovy a Ústřední vojenská nemocnice Praha
přednosta: prof. MUDr. M. Zavoral, PhD.
1; Chirurgická klinika 2. LF Univerzity Karlovy a Ústřední vojenská nemocnice Praha
přednosta: prof. MUDr. M. Ryska, CSc.
2; Ústav analytické chemie, Vysoká škola chemicko-technologická v Praze
vedoucí pracoviště: prof. RNDr. Š. Urban, CSc.
3
Published in:
Rozhl. Chir., 2017, roč. 96, č. 9, s. 369-374.
Category:
Review
Overview
Pancreatic cancer is a malignancy, which usually carries a poor prognosis; the 5-year survival is less than 6%. Therefore, its early detection in a stage when curable resection can be performed is essential to give the patients the best possible chance for a long-term survival. Despite the use of the most up-to-date diagnostic procedures, an early diagnosis of pancreatic carcinoma is rather unsuccessful. Furthermore, long-term survival rates for pancreatic cancer patients are still unsatisfactory, even when diagnosed early. Nevertheless, alterations occur in biomolecules as early as during the onset of oncogenesis, which can be detected by structure-sensitive spectroscopic methods. These methods provide a potential for detecting a sufficiently specific biomarker of early pancreatic carcinoma. A pilot study using molecular spectroscopy was conducted at the 1st Department of Internal Medicine, 1st Faculty of Medicine, Charles University and Military University Hospital in Prague, Czech Republic, in cooperation with the Department of Analytical Chemistry, University of Chemistry and Technology in Prague, Czech Republic. In the study, we compared the spectral response of blood plasma of patients with pancreatic carcinoma and healthy controls. Molecular spectroscopy provided evidence of significant differences between the two groups as illustrated by the study results. This approach thus might be suitable for detecting a specific biomarker of early pancreatic carcinoma. The findings have forced us to rethink the practical benefits of all potential biomarkers. In the future, we might face a situation where although any given marker is positive in a patient, no convincing morphological correlation can be found using available imaging methods. An important question is thus raised – whether or not to indicate surgical resection only on the basis of the biomarker positivity, and what type of resection to opt for.
Key words:
pancreatic cancer – early detection – spectroscopy – pancreatectomy
Sources
1. Trends in SEER incidence and U.S. mortality using the Joinpoint Regression Program, 1975–2011 with up to five Joinpoints, 1992–2011 with up to three Joinpoints, both sexes by race/ethnicity [online]. Available from https://seer.cancer.gov/archive/csr/1975_2011/results_merged/sect_22_pancreas.pdf.
2. Haeno H, Gonen M, Davis MB, et al. Computational modeling of pancreatic cancer reveals kinetics of metastasis suggesting optimum treatment strategies. Cell 2012;148:362–75.
3. Yachida S, Jones S, Bozic I, et al. Distant metastasis ocurs late during the genetic evolution of pancreatic cancer. Nature 2010;467:1114–7.
4. Tatarkovič M, Miškovicová M, Šťovíčková L, et al. The potential of chiroptical and vibrational spectroscopy of blood plasma for the discrimination between colon cancer patients and the control group. Analyst 2015;140:2287–93.
5. Šťovíčková L, Tatarkoviš M, Logerová H, et al. Identification of spectral biomarkers for type 1 diabetes mellitus using the combination of chiroptical and vibrational spectroscopy. Analyst 2015;140:2266–72.
6. Moravec Z, Košařová V. Molekulová spektroskopie [online] Available from http://www.sci.muni.cz/chemsekce/frvs2011/pdf/mol-spec.pdf.
7. Wagnière GH. On the interaction of light with molecules: Pathways to the theoretical interpretation of chiroptical phenomena. In: Berova N, Polavarapu PL, Nakanishi K, at al. Comprehensive chiroptical spectroscopy. New Jersey, USA, Hoboken 2012:3–35.
8. Tatarkovič M, Synytsya A, Šťovíčková L, et al. The minimizing of fluorescence background in Raman optical activity and Raman spectra of human blood plasma. Anal Bioanal Chem 2015;407:1335–42.
9. Bunganič B, Šťovíčková L, Tatarkovič M, et al. Molekulárně spektroskopická analýza krevní plazmy – cesta k diagnostice karcinomu pankreatu? Gastroent Hepatol 2015;69:518–24.
10. Fukamachi K, Tanaka H, Hagiwara Y, et al. An animal model of preclinical diagnosis of pancreatic ductal adenocarcinomas. Biochem Biophys Res Commun 2009;390:636–41.
11. Itzkowitz SH, Kim YS. New carbohydrate tumor markers. Gastroenterology 1986;90:491–4.
12. Shounak M, Suresh TCH, David AA. Molecular detection of pancreatic neoplasia: Current status and future promise. World J Gastroenterol 2015;21:11387–95.
13. Kaur S, Kumar S, Momi N, et al. Mucins in pancreatic cancer and its microenvironment. Nat Rev Gastroenterol Hepatol 2013;10:607–20.
14. Wen S, Li Z, Feng J, et al. Metabonomic changes from pancreatic intraepithelial neoplasia to pancreatic ductal adenocarcinoma in tissues from rats. Cancer Sci 2016;107:836–45.
15. Kenner BJ, Chari ST, Maitra A, et al. Early detection of pancreatic cancer − a defined future using lessons from other cancers: A white paper. Pancreas 2016;45:1073–9.
16. Brune K, Abe T, Canto M, et al. Multifocal neoplastic precursor lesions associated with lobular atrophy of the pancreas in patients having a strong family history of pancreatic cancer. Am J Surg Pathol 2006;30:1067–76.
17. Krishna SG, Rao BB, Ugbarugba E, et al. Diagnostic performance of endoscopic ultrasound for detection of pancreatic malignancy following an indeterminate multidetector CT scan: a systemic review and meta-analysis. Surg Endosc 2017; [Epub ahead of print].
18. Tamm EP, Loyer EM, Faria SC, et al. Retrospective analysis of dual-phase MDCT and follow-up EUS/EUS-FNA in the diagnosis of pancreatic cancer. Abdom Imaging 2007;32:660–7.
19. Rulyak SJ, Brentnall TA. Inherited pancreatic cancer: Surveillance and treatment strategies for affected families. Pancreatology 2001;1:447–85.
20. Canto MI, Hruban RH, Fishman EK, et al. American Cancer of the Pancreas Screening (CAPS) Consortium. Frequent detection of pancreatic lesions in asymptomatic high-risk individuals. Gastroenterology 2012;142:796–804.
21. Poley JW, Kluijt I, Gouma DJ, et al. The yield of first-time endoscopic ultrasonography in screening individuals at a high risk of developing pancreatic cancer. Am J Gastroenterol 2009;104:2175–81.
22. Ludwig E, Olson SH, Bayuga AS, et al. Feasibility and yield screening in relatives from familial pancreatic cancer families. Am J Gastroenterol 2011;106:946–54.
23. Hanada K, Okayaki A, Hirano N, et al. Diagnostic strategies for early pancreatic cancer. J Gastroenterol 2015;50:147–54.
24. Iskandar EM, Wayne GM, Steele GJ. Familial pancreatic cancer. The case for prophylactic pancreatectomy in lieu of serial screening and shared decision making. Case Rep Oncol Med 2014; Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4258333/.
25. Ryska M, Rudiš J. Totální pankreatektomie u maligního onemocnění slinivky břišní – od historie k dnešku. Rozhl Chir 2016; 95:345–9.
26. Almond M, Roberts KJ, Hodson J, et al. Changing indications for a total pancreatectomy: perspectives over a quarter of a century. HPB 2015;17:416−21.
27. Hartwig W, Gluth A, Hinz U, et al. Total pancreatectomy for primary pancreatic neoplasms. Ann Surg 2015;261:537−46.
28 Johnston WC, Hoen HM, Cassera MA, et al. Total pancreatectomy for pancreatic ductal adenocarcinoma: review of the National Cancer Data Base. HPB 2016;18:21−8.
29. Ryska M. Totální pankreatektomie a její současné místo v léčbě onemocnění pankreatu. Gastroent Hepatol 2016;70:408−12.
30. Murphy MM, Knaus WJ, NG SC, et al. Total pancreatectomy: a national study. HPB : The Official Journal of the International Hepato Pancreato Biliary Association 2009;11:476–82.
31. Čečka F, Jon B, Šubrt Z, et al. Pankreatická píštěl – Definice, rizikové faktory a možnosti léčby. Rozhl Chir 2013;92:77−84.
32. Watanabe Y, Ohtsuka T, Matsunage T, et al. Long-term outcomes after total pancreatectomy: special reference to survivors´ living conditions and quality of life. World J Surg 2015;39:1231−9.
33. Epelboym I, Winner M, DiNorcia J, et al. Quality of life in patients after total pancreatectomy is comparable with quality of life in patiens who undergo a partial pancreatic resection. JSR 2014;187:189−96.
34. Boggi U, Amorese G., Vistoli F, et al. Laparoscopic pancreaticoduodenectomy: A systematic literature review. Sugical Endoscopy 2015;29:9–23.
35. Čečka F, Ferko A, Jon B, et al. Laparoskopická resekce pankreatu v experimentu a klinické praxi. Rozhl Chir 2011;90:194−9.
Labels
Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2017 Issue 9
Most read in this issue
-
Hamartoma of the abdominal cavity and retroperitoneum
– a review and a case report - Pneumoperitoneum after colonoscopy – “to cut or not to cut”
- Current application and future perspectives of capsule colonoscopy
- Diagnosis of early pancreatic cancer and precursor lesions