Prospective Study Using Plasma Apolipoprotein A2-Isoforms to Screen for High-Risk Status of Pancreatic Cancer.

Abstract

Apolipoprotein A2-ATQ/AT (apoA2-ATQ/AT) has been identified as a minimally invasive biomarker for detecting pancreatic cancer (PC) and high-risk (HR) individuals for PC. To establish an efficient enrichment strategy for HR, we carried out a plasma apoA2-ATQ/AT level-based prospective screening study among the general population. The subjects for the screening study were recruited at six medical check-up facilities in Japan between October 2015 and January 2017. We evaluated the positive predictive value (PPV) of the plasma apoA2-ATQ/AT level of ≤35 μg/mL for detecting PC and HR. Furthermore, we prospectively confirmed its diagnostic accuracy with another post-diagnosis population in a cross-sectional study. We enrolled 5120 subjects in experimental screening, with 84 subjects (1.3%) showing positive results for apoA2-ATQ/AT. Pancreatic abnormalities were recognized in 26 of the 84 subjects from imaging examinations. Pancreatic abnormalities detected included 1 PC and 15 HR abnormalities, such as cystic lesions including intraductal papillary mucinous neoplasm. The PPV of apoA2-ATQ/AT for detecting PC and HR was 33.3%. Moreover, a combination study with another cross-sectional study revealed that the area under the curve for apoA2-ATQ/AT to distinguish PC from healthy controls was 0.903. ApoA2-ATQ/AT has the potential to enrich PC and HR by increasing the diagnostic probability before imaging examinations.

• Authors: Yu Sato, Takashi Kobayashi, Shin Nishiumi, Akihiko Okada, Tsuyoshi Fujita, Tsuyoshi Sanuki, Masao Kobayashi, Masakyo Asahara, Masayasu Adachi, Arata Sakai, Hideyuki Shiomi, Atsuhiro Masuda, Masaru Yoshida, Keiko Takeuchi, Yuzo Kodama, Hiromu Kutsumi, Kengo Nagashima, Kazufumi Honda
• Journal: Cancers (Cancers (Basel)) Vol. 12 Issue 9 (Sep 14 2020) ISSN: 2072-6694 [Print] Switzerland
• PMID: 32937962 (Publication Type: Journal Article)