Thrombospondin‑2 as a diagnostic biomarker for distal cholangiocarcinoma and pancreatic ductal adenocarcinoma

• J. Byrling ^[1] ; K. S. Hilmersson ^[1] ; D. Ansari ^[1] ; R. Andersson ^[1] ; B. Andersson ^[1]
  1. [1] Department of Surgery, Clinical Sciences Lund, Surgery, Lund University and Skåne University Hospital, 221 85 Lund, Sweden
• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 24, Nº. 2, 2022, págs. 297-304
• Idioma: inglés
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• Resumen

  • Purpose Distal cholangiocarcinoma and pancreatic ductal adenocarcinoma are malignancies with poor prognoses that can be difficult to distinguish preoperatively. Thrombospondin-2 has been proposed as a novel diagnostic biomarker for early pancreatic ductal adenocarcinoma. The aim of the present study was to evaluate thrombospondin-2 as a diagnostic and prognostic biomarker in combination with current biomarker CA 19-9 for distal cholangiocarcinoma and pancreatic ductal adenocarcinoma.

    Methods Thrombospondin-2 was measured in prospectively collected serum samples from patients who underwent surgery with a histopathological diagnosis of distal cholangiocarcinoma (N = 51), pancreatic ductal adenocarcinoma (N = 52) and benign pancreatic diseases (N= 27) as well as healthy blood donors (N= 52) using an enzyme-linked immunosorbent assay.

    Results Thrombospondin-2 levels (ng/ml) were similar in distal cholangiocarcinoma 55 (41–77) and pancreatic ductal adeno- carcinoma 48 (35–80) (P = 0.221). Thrombospondin-2 + CA 19-9 had an area under the curve of 0.92 (95% CI 0.88–0.97) in differentiating distal cholangiocarcinoma and pancreatic ductal adenocarcinoma from healthy donors which was superior to CA 19-9 alone (P < 0.001). The diagnostic value of adding thrombospondin-2 to CA 19-9 was larger in early disease stages. Thrombospondin-2 did not provide additional value to CA 19-9 in differentiating the benign disease group; however, heterogeneity was notable in the benign cohort. Three of five patients with autoimmune pancreatitis patients had greatly elevated thrombospondin-2 levels. Thrombospondin-2 levels had no correlation with prognoses.

    Conclusions Serum thrombospondin-2 in combination with CA 19-9 has potential as a biomarker for distal cholangiocar - cinoma and pancreatic cancer.