Abstract
BackgroundPancreatic adenocarcinoma (PDAC) is an incurable cancer without adequate tumor markers. Our previous study has showed a better diagnostic performance of Protein Induced by Vitamin K Absence II (PIVKA-II) compared to currently used PDAC biomarkers. To corroborate our previous data with a larger sample size and to assess a possible role of PIVKA-II in predicting surgical success. Additionally, to further evaluate the hypothesis of a direct PIVKA-II production by PDAC cells, we examined PIVKA-II tissue expression in a case of PDAC using immunofluorescence.MethodsWe enrolled 76 newly diagnosed PDAC patients and selected 11 patients to determine PIVKA-II levels also after surgical resection. An immunofluorescence (IF) study of PIVKA-II tissue expression was carried out in one of them. PIVKA-II serum values were measured by chemiluminescent enzyme immunoassay method (CLEIA) on LUMIPULSE G1200 (Fujirebio-Europe, Belgium).ResultsPIVKA-II serum levels were above the cut-off at baseline in 71 patients (94%) with a median value of 464 mAU/Ml (range 27–40783 mAU/mL); the sensitivity and specificity were 78.67% and 90.67% respectively. Patients with pre-operative PIVKA-II positivity showed a significant decrease (P < 0.015) of median PIVKA-II serum concentrations after surgery: 820 (91–40783) mAU/mL at diagnosis vs 123 (31–4666) mAU/mL post-operatively. IF assay on PDAC sections demonstrated PIVKA-II expression in cancer cells.ConclusionThese data are the first showing a decreased PIVKA-II serum levels after surgery in PDAC patients and reporting PIVKA-II expression in PDAC tissue. Further studies are needed to confirm these findings and to determine PIVKA-II usefulness in diagnosing and monitoring PDAC patients.
Highlights
Pancreatic cancer is a lethal malignancy representing the seventh leading cause of global cancer deaths in industrialized countries
In a recent preliminary study investigating a novel serum biomarker for Pancreatic adenocarcinoma (PDAC), we evaluated Prothrombin induced by vitamin K absence-II (PIVKA-II) values in a cohort of PDAC Italian patients [7]
Until the 1980’s, the resulting protein, PIVKA-II, was mainly used as an indicator of blood coagulability but since Liebman et al in 1984 reported detection of a high rate of serum PIVKA-II in hepatocellular carcinoma (HCC) patients, this biomarker has been widely used for this neoplasm and it presently represents an important tool in the diagnosis and prognosis [9,10,11]
Summary
Pancreatic cancer is a lethal malignancy representing the seventh leading cause of global cancer deaths in industrialized countries. Until the 1980’s, the resulting protein, PIVKA-II, was mainly used as an indicator of blood coagulability but since Liebman et al in 1984 reported detection of a high rate of serum PIVKA-II in hepatocellular carcinoma (HCC) patients, this biomarker has been widely used for this neoplasm and it presently represents an important tool in the diagnosis and prognosis [9,10,11] Anyway it has recently been reported (mainly from Japan) the presence of elevated PIVKA-II values in different kinds of in other gastrointestinal neoplasms such as gastric cancer, colon cancer and PDAC [7]. To further evaluate the hypothesis of a direct PIVKA-II production by PDAC cells, we examined PIVKA-II tissue expression in a case of PDAC using immunofluorescence
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