Abstract
Pancreatic cancer screening has been hampered by the high rate of complications associated with interrogating the pancreas. The closest non-invasively accessible mucosa available for pancreatic cancer screening is the periampullary duodenal tissue. Our earlier report has shown the potential of using optical markers to interrogate this tissue for the presence of pancreatic cancer. In this study, we report a larger data set of low-coherence enhanced backscattering (LEBS) and elastic light scattering fingerprinting (ELF) optical markers from the periampullary duodenal mucosa. Optical measurements from biopsy samples were acquired from a total of 203 patients with varying clinical classification including healthy controls, a family history of pancreatic cancer, pancreatitis, mucinous cystic precursor lesions, pancreatic cancer, and other pancreatic malignancies. Evaluation of the performance of an independent testing set for discriminating healthy control patients from pancreatic cancer patients showed a 95% sensitivity, 71% specificity, and 85% area under the receiver operator characteristic (AUROC) curve. Importantly, this performance was uncompromised for detecting potentially curable stages of the disease. Additionally, optical markers in higher risk populations such as family history and pancreatitis had values between those of healthy control and pancreatic cancer patients, thus allowing for future investigations of screening from these high risk groups.
Highlights
Pancreatic cancer is one of the deadliest cancers with a 5 year survival rate of less than 5% and is the 4th largest cause of cancer-related deaths in the United States [7]
There is a need to identify a subset of the general population that has a higher prevalence of the disease in whom one could justify the cost and potential risks associated with an early detection strategy
The age, gender, and race distribution for periampullary biopsy patients are shown for each clinical classification in Table 1. 44 patients were diagnosed with pancreatic adenocarcinomas, of which 26 were resectable
Summary
Pancreatic cancer is one of the deadliest cancers with a 5 year survival rate of less than 5% and is the 4th largest cause of cancer-related deaths in the United States [7]. There is a need to identify a subset of the general population that has a higher prevalence of the disease in whom one could justify the cost and potential risks associated with an early detection strategy. Even if an effective early detection approach is applied to these patients, only a minority of pancreatic cancer cases would be impacted because a maximum of only 10% of all diagnosed patients have a family history [24]. Despite this small contribution, screening this high risk group has the potential to save many lives
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