Exosomal glypican-1 discriminates pancreatic ductal adenocarcinoma from chronic pancreatitis. Issue 7 (July 2022)

• Record Type: Journal Article
• Authors: Moutinho-Ribeiro, P.; Adem, B.; Batista, I.; Silva, M.; Silva, S.; Ruivo, C.F.; Morais, R.; Peixoto, A.; Coelho, R.; Costa-Moreira, P.; Lopes, S.; Vilas-Boas, F.; Durães, C.; Lopes, J.; Barroca, H.; Carneiro, F.; Melo, S.A.; Macedo, G.
• Is Part Of: Digestive and liver disease. Volume 54:Issue 7(2022)
• Page Start: 871
• Page End: 877
• Publication Date: 2022-07
• Subjects: Chronic pancreatitis -- Glypican-1 -- CA 19.9 -- Endoscopic ultrasound -- Pancreatic ductal adenocarcinoma; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2021.10.012
• Languages: English
• ISSNs: 1590-8658

Abstract

Abstract: Background and aims: Pancreatic ductal adenocarcinoma (PDAC) diagnosis can be difficult in a chronic pancreatitis (CP) background, especially in its mass forming presentation. We aimed to assess the accuracy of glypican-1-positive circulating exosomes (GPC1 + crExos) to distinguish PDAC from CP versus the state-of-the-art CA 19–9 biomarker. Methods: This was a unicentric prospective cohort. Endoscopic ultrasound with fine-needle aspiration or biopsy and blood tests (GPC1 + crExos and serum CA 19–9) were performed. Results: The cohort comprised 60 PDAC and 29 CP (7 of which mass forming - MF) patients. Median levels of GPC1 + crExos were significantly higher in PDAC (99.7%) versus CP (28.4%; p <0.0001) with an AUROC of 0.96 with 98.3% sensitivity and 86.2% specificity for a cut-off of 45.0% ( p <0.0001); this outperforms CA 19–9 AUROC of 0.82 with 78.3% sensitivity and 65.5% specificity at a cut-off of 37 U/mL ( p <0.0001). The superiority of% GPC1+crExos over CA 19–99 in differentiating PDAC from CP was observed in both early (stage I) and advanced tumors (stages II-IV). Conclusion: Levels of GPC1 + crExos coupled to beads enable differential diagnosis between PDAC and CP including its mass-forming presentation.