Circulating Thrombospondin-2 enhances prediction of malignant intraductal papillary mucinous neoplasm - 17/02/19
, C. Max Schmidt a, b, e, f, g, ⁎ Abstract |
Background |
IPMNs are cystic pancreatic lesions with variable malignant potential. Thrombospondin-2 (THBS2)—an endogenous, anti-angiogenic matrix glycoprotein—may modulate tumor progression. We hypothesized that circulating levels of THBS2 could aid in preoperative prediction of malignant IPMN.
Methods |
Preoperative serum/plasma samples were procured from patients undergoing surgery. Circulating levels of THBS2 were measured (enzyme-linked immunosorbent assay) and compared to surgical pathology IPMN dysplastic grade.
Results |
164 patients underwent THBS2 testing (100 Low/Moderate-IPMN; 64 High-Grade/Invasive-IPMN). Circulating THBS2 (mean ± SD) was greater in High-Grade/Invasive-IPMN than Low/Moderate-grade IPMN (26.6 ± 12.7 ng/mL vs. 20.4 ± 8.2 ng/mL; P < 0.001). THBS2 (AUC = 0.65) out-performed CA19-9 (n = 144; AUC = 0.59) in predicting IPMN grade. The combination of THBS2, CA19-9, radiographic main-duct involvement, main-duct diameter, age, sex, and BMI (AUC 0.82; n = 137) provided a good prediction model for IPMN grade.
Conclusion |
Circulating THBS2 is correlated with IPMN dysplasia grade. THBS2 alone did not strongly predict IPMN grade but rather strengthened prediction models for High-Grade/Invasive IPMN when combined with other clinical/biomarker data.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Optimal management of IPMN relies on the ability to determine high-risk lesions (i.e. harbor HGD or Invasive disease). |
• | THBS2 alone modestly predicted IPMN dysplasia grade and enhanced predictive models when combined with clinical features. |
• | THBS2 may assist in recommending surgery for high-risk disease while avoiding unnecessary resection of low-risk lesions. |
Keywords : Pancreatic cyst, Intraductal papillary mucinous neoplasm, IPMN, Pancreatic cancer, Thrombospondin-2, Biomarker
Abbreviations : Intraductal papillary mucinous neoplasm, High Grade Dysplasia, Thrombospondin-2, Body mass index, Area under the curve, Pancreatic Ductal Adenocarcinoma, Pancreatic Stellate Cell
Plan
Vol 217 - N° 3
P. 425-428 - mars 2019 Retour au numéro
Article précédent
- A targeted initiative to discharge surgical patients earlier in the day is associated with decreased length of stay and improved hospital throughput
- Circulating thrombospondin-2 enhances prediction of malignant intraductal papillary mucinous neoplasm
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