Abstract
Background and Aims: Early detection of pancreatic adenocarcinoma is critical for successful treatment. However, biomarkers useful for early diagnosis or distinguishing between adenocarcinoma and chronic pancreatitis are not available. In the current study we verified the differential expression of CEACAM1, localized CEACAM1 expression, and compared CEACAM1 levels in the serum of pancreatic cancer patients and age and sex matched normal controls. Methods: CEACAM1 mRNA levels were measured using Q-RT-PCR. CEACAM1 was localized by immunohistochemistry. CEACAM1 serum levels were assessed by a double determinant ELISA and compared to levels of CA19-9 and CEA measured using commercially available ELISA assays. Results: CEACAM1 mRNA levels were 380-fold higher in microdissected samples of pancreatic adenocarcinomas compared to normal pancreas. CEACAM1 protein was localized to neoplastic cells in 96% (46 of 48) adenocarcinomas as well as to dysplastic duct cells in 64% (14 of 22) PanIn lesions (grade III). Using a cut-off value of 5 ng/ml, CEACAM1 levels were significantly elevated in 69% (35 of 51) patients with pancreatic adenocarcinoma compared to 2% (1 of 55) normal patients. In comparison, CA19-9 and CEA levels measured in the same samples using cut-off values of 5 U/ml and 10 ng/ml, respectively, detected 49% (25 of 51) and 18% (9/51) of cancer patients. ROC curves generated and revealed that CEA1 is more sensitive and specific than Ca 19-9 or CEA in differentiating pancreatic cancer from normal samples. Furthermore, use of CEACAM1 in conjunction with CA19-9 had significantly higher sensitivity and specificity than either biomarker alone. Conclusions: CEACAM1 is differentially expressed in pancreatic adenocarcinoma and serum levels of CEACAM1 are elevated in patients with pancreatic cancer. Measurement of serum CEACAM1 may be helpful in the diagnosis of pancreatic cancer.
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