title: Serum markers in patients with resectable pancreatic adenocarcinoma: macrophage inhibitory cytokine 1 versus CA19-9.
abstract: OBJECTIVE
  More accurate serum markers of pancreatic cancer could improve the early detection and prognosis of this deadly disease. We compared the diagnostic utility of a panel of candidate serum markers of pancreatic cancer.
  
  
  METHODS
  We collected preoperative serum from 50 patients with resectable pancreatic adenocarcinoma, as well as sera from 50 patients with chronic pancreatitis and 50 age/sex-matched healthy controls from our institution. Sera were analyzed for the following candidate markers of pancreatic cancer: CA19-9, macrophage inhibitory cytokine 1 (MIC-1), osteopontin, tissue inhibitor of metalloproteinase 1, and hepatocarcinoma-intestine-pancreas protein levels.
  
  
  RESULTS
  By logistic regression analysis, MIC-1 and CA19-9 were significant independent predictors of diagnosis. Receiver operating characteristic curve analysis showed that MIC-1 was significantly better than CA19-9 in differentiating patients with pancreatic cancer from healthy controls (area under the curve is 0.99 and 0.78, respectively; P = 0.003), but not in distinguishing pancreatic cancer from chronic pancreatitis (area under the curve of 0.81 and 0.74, respectively; P = 0.63). Hepatocarcinoma-intestine-pancreas/pancreatitis-associated protein, osteopontin, and tissue inhibitor of metalloproteinase 1 serum levels did not provide additional diagnostic power.
  
  
  CONCLUSIONS
  In the differentiation of patients with resectable pancreatic cancer from controls, serum MIC-1 outperforms other markers including CA19-9.
authors.affiliation: Department of Pathology, Johns Hopkins Medical Institutions, 720 Rutland Avenue, Baltimore, MD 21205-2196, USA.
authors.forename: Jens
authors.initials: J
authors.lastname: Koopmann
authors.forename: C Nicole White
authors.initials: CN
authors.lastname: Rosenzweig
authors.forename: Zhen
authors.initials: Z
authors.lastname: Zhang
authors.forename: Marcia I
authors.initials: MI
authors.lastname: Canto
authors.forename: David A
authors.initials: DA
authors.lastname: Brown
authors.forename: Mark
authors.initials: M
authors.lastname: Hunter
authors.forename: Charles
authors.initials: C
authors.lastname: Yeo
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Chan
authors.forename: Samuel N
authors.initials: SN
authors.lastname: Breit
authors.forename: Michael
authors.initials: M
authors.lastname: Goggins
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000601:surgery; D000368:Aged; D000951:Antigens, Neoplasm / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood*; D016022:Case-Control Studies; D016207:Cytokines / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D055436:Growth Differentiation Factor 15; D006801:Humans; D037181:Lectins, C-Type / Q000097:blood; D008297:Male; D008875:Middle Aged; D053495:Osteopontin; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000601:surgery; D050500:Pancreatitis, Chronic / Q000097:blood / Q000601:surgery; D000073718:Pancreatitis-Associated Proteins; D011379:Prognosis; D012795:Sialoglycoproteins / Q000097:blood; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D016207:Cytokines; C526140:GDF15 protein, human; D055436:Growth Differentiation Factor 15; D037181:Lectins, C-Type; D000073718:Pancreatitis-Associated Proteins; C000612141:REG3A protein, human; C506895:SPP1 protein, human; D012795:Sialoglycoproteins; D019715:Tissue Inhibitor of Metalloproteinase-1; D053495:Osteopontin