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1. Thirty-eight microRNAs were discovered to be differentially expressed in whole blood between patients with pancreatic cancer and healthy controls.
2. Many microRNAs found to be differentially expressed in patients with pancreatic cancer were associated with known oncogenes and signaling pathways.
Evidence Rating Level: 3 (Average)
Study Rundown: Pancreatic cancer causes significant mortality in the Western world in part due to the fact that many pancreatic cancers are detected at advanced stages. The high mortality associated with pancreatic cancer could be possibility be prevented with early detection of the disease. A number of retrospective studies have described microRNAs in the serum or plasma that differ between patients with pancreatic cancer and healthy controls. In this current study, whole blood samples from patients with pancreatic cancer and healthy controls were used to identify microRNAs that can be used for the early diagnosis of pancreatic cancer. Two diagnostic panels were created from these microRNAs and demonstrated the ability to distinguish between patients with pancreatic cancer and healthy controls. The major strength of this study was in the large numbers of patients and the large microRNA panels that were used for discovery. However, the study was limited in generalizability as all of the cohorts were from one genetic, ethnic and geographic background. Overall, the study does provide evidence of biomarkers in whole blood that could potentially be used to screen for pancreatic cancer and argues for further research on the applicability of these markers in practice.
Click to read the study, published today in JAMA
Click to read an accompanying editorial, published today in JAMA
Relevant Reading: Potential epigenetic biomarkers for the diagnosis and prognosis of pancreatic ductal adenocarcinomas
In-Depth [case-control study]: This study used whole blood samples from 435 patients with suspected pancreatic cancer to find blood biomarkers for the early detection of pancreatic cancer. These were first separated into three randomly determined subcohorts: a discovery cohort, a training cohort and a validation cohort. The discovery cohort identified 38 unique microRNAs that differed between patients with pancreatic cancer and those that were healthy. When these were tested in a training cohort, two biomarker panels, index I (miR=145, miR-150, miR-223, miR-636) and index II (miR-26b, miR-34a, miR-122, miR-126, miR-145, miR-150, miR-223, miR-505, miR-636, miR-885.5p) were constructed. By combining the panels with serum CA19-9 with serum CA19-9, for index I AUC increased to 0.83 (95% CI, 0.76-0.90), specificity increased to 0.96 (95% CI, 0.62-0.84) and accuracy increased to 0.92 (95% CI, 0.89-0.95) but sensitivity decreased to 0.74 (95% CI, 0.76-0.90). For index II with CA19-9, specificity increased to 0.97 (95% CI, 0.94-0.99) and accuracy increased to 0.93 (95% CI, 0.90 – 0.95); however AUC remained 0.91 (95% CI, 0.86 – 0.95) and sensitivity decreased to 0.73 (95% CI, 0.61 – 0.83).
By Camellia Banerjee and Brittany Hasty
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