The specificity of amylin for the diagnosis of pancreatic adenocarcinoma.
BACKGROUND
Diabetes mellitus or impaired glucose tolerance occurs in up to 80% of patients with pancreatic cancer at the time of cancer diagnosis. It has been reported that plasma amylin (islet amyloid polypeptide [IAPP]) levels are elevated in all patients with pancreatic cancer who are diabetic, and even moderately elevated in pancreatic cancer patients with normal glucose tolerance.


OBJECTIVE
To determine the specificity of elevated amylin levels for pancreatic cancer.


METHODS
Plasma amylin levels were determined in 168 patients with one or more of the following medical conditions: benign and malignant biliary obstruction, pancreatic cancer, chronic pancreatitis, acute pancreatitis, other gastrointestinal (GI) malignancies, and newly diagnosed type II diabetes.


RESULTS
Elevated levels of plasma amylin were detected in several disorders other than pancreatic cancer--particularly chronic pancreatitis, other GI malignancies, and biliary obstruction from benign causes. No statistical differences in amylin levels were detected for any of the tested medical conditions when compared to pancreatic adenocarcinoma.


CONCLUSIONS
These results suggest that elevated plasma amylin is not specific for pancreatic cancer, thereby limiting its role as a tumor marker. Further studies are needed to determine whether amylin, if used in conjunction with other biological markers, could be useful for the diagnosis of pancreatic cancer.
Brand
Randall E
RE
Department of Internal Medicine, Evanston Northwestern Healthcare, Glenview, IL 60025, USA. rbrand@enh.org
Ding
Xian-Zhong
XZ
Young
Christine M
CM
Adrian
Thomas E
TE
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology*; D000328:Adult; D000368:Aged; D000682:Amyloid / Q000097:blood*; D014408:Biomarkers, Tumor / Q000032:analysis*; D002779:Cholestasis / Q000175:diagnosis; D003924:Diabetes Mellitus, Type 2; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D058228:Islet Amyloid Polypeptide; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D010195:Pancreatitis / Q000175:diagnosis; D011863:Radioimmunoassay; D012680:Sensitivity and Specificity
D000682:Amyloid; D014408:Biomarkers, Tumor; D058228:Islet Amyloid Polypeptide