We recently reported the usefulness of apolipoprotein A2 isoforms (apoA2-i) as a plasma/serum biomarker for the early detection of pancreatic cancer (PC) and its risk diseases, and the level of ApoA2-ATQ/AT, which is one of apoA2-i, was significantly decreased in early stage PC and risk diseases. To evaluate the possibility of usefulness as the screening biomarker, we prospectively tested the performance of ApoA2-ATQ/AT as a first screening method for PC and its risk diseases in general population.
Study participants were prospectively enrolled from the subjects of medical checkup at 6 institutions between Oct 2015 and Jan 2017. We measured the plasma level of ApoA2-ATQ/AT by using ELISA, and all participants with the positive results from the level of ApoA2-ATQ/AT (ApoA2-ATQ/AT < 35 μg/mL) were recommended for 2nd examination with contrast enhanced-CT (CECT), MRI, or EUS.
Among a total of 5,120 participants registered in this study, 83 were positive (Positive rate: 1.6%). In the 83 subjects with the positive results, 55 (66.3%) underwent 2nd examination. Finally, pancreatic diseases were detected in 23 (41.8%) of 55. They included 1 PC, 12 pancreatic cystic lesions (PCL), and 3 chronic pancreatitis (CP). Furthermore, 14.5% of ApoA2-ATQ/AT positive subjects had abnormal ultrasonographic findings in the pancreas, while the subjects with ultrasonographic abnormalities of the pancreas under a medical checkup were 3.2% of the participants who underwent transabdominal ultrasonography. Taken together, ApoA2-ATQ/AT could significantly accumulate the subjects with abnormal ultrasonographic findings by 4.53 times in comparison with a normal medical checkup for general population.
Plasma ApoA2-ATQ/AT as a first screening method in general population could improve an efficiency of detection of PC and its high-risk diseases.
Clinical trial identification
Legal entity responsible for the study
Kobe University Graduate School of Medicine, Department of Gastroenterology.
Japan Agency for Medical Research and Development.
All authors have declared no conflicts of interest.