title: Usefulness of MALDI-TOF/MS identification of low-MW fragments in sera for the differential diagnosis of pancreatic cancer.
abstract: OBJECTIVE
  To identify new biomarkers of pancreatic cancer (PaCa), we performed MALDI-TOF/MS analysis of sera from 22 controls, 51 PaCa, 37 chronic pancreatitis, 24 type II diabetes mellitus (DM), 29 gastric cancer (GC), and 24 chronic gastritis (CG).
  
  
  METHODS
  Sera were purified by Sep-Pak C18 before MALDI-TOF/MS Anchorchip analysis.
  
  
  RESULTS
  Features present in at least 5% of all spectra were selected (n = 160, m/z range, 1200-5000). At univariate analysis, 2 features (m/z 2049 and 2305) correlated with PaCa, 3 (m/z 1449, 1605, and 2006) with DM. No feature characterized gastric cancer or chronic gastritis. Ten-fold cross-validation binary recursive partitioning trees were obtained for patients' classification. The tree (CA 19-9, age, m/z 2006, 2599, 2753, and 4997), built considering only patients with diabetes, allowed a distinction between DM [area under the receiver operating characteristic curve (AUC), 0.997], chronic pancreatitis (AUC, 0.968), and PaCa (AUC, 0.980), with an overall correct classification rate of 89%. The tree including CA 19-9, 1550, and 2937 m/z features, achieved an AUC of 0.970 in distinguishing localized from advanced PaCa. MALDI-TOF-TOF analysis revealed the 1550 feature as a fragment of Apo-A1, which was determined as whole protein and demonstrated to be closely correlated with PaCa.
  
  
  CONCLUSIONS
  The findings made demonstrate a role for serum peptides identified using MALDI-TOF/MS for addressing PaCa diagnosis.
authors.affiliation: Department of Laboratory Medicine, University of Padova, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Padoan
authors.forename: Roberta
authors.initials: R
authors.lastname: Seraglia
authors.forename: Daniela
authors.initials: D
authors.lastname: Basso
authors.forename: Paola
authors.initials: P
authors.lastname: Fogar
authors.forename: Cosimo
authors.initials: C
authors.lastname: Sperti
authors.forename: Stefania
authors.initials: S
authors.lastname: Moz
authors.forename: Eliana
authors.initials: E
authors.lastname: Greco
authors.forename: Alberto
authors.initials: A
authors.lastname: Marchet
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Manzoni
authors.forename: Carlo-Federico
authors.initials: CF
authors.lastname: Zambon
authors.forename: Filippo
authors.initials: F
authors.lastname: Navaglia
authors.forename: Luigi
authors.initials: L
authors.lastname: Cristadoro
authors.forename: Alda
authors.initials: A
authors.lastname: Di Chiara
authors.forename: Donato
authors.initials: D
authors.lastname: Nitti
authors.forename: Sergio
authors.initials: S
authors.lastname: Pedrazzoli
authors.forename: Girolamo
authors.initials: G
authors.lastname: Pavanello
authors.forename: Mario
authors.initials: M
authors.lastname: Plebani
mesh_terms: D000368:Aged; D016632:Apolipoprotein A-I / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood* / Q000737:chemistry; D018395:CA-19-9 Antigen / Q000097:blood; D016022:Case-Control Studies; D051152:Clusterin / Q000097:blood; D003176:Complement C3 / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D005756:Gastritis / Q000097:blood / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008970:Molecular Weight; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000175:diagnosis*; D050500:Pancreatitis, Chronic / Q000097:blood / Q000175:diagnosis; D010446:Peptide Fragments / Q000097:blood* / Q000737:chemistry; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / Q000379:methods*; D013274:Stomach Neoplasms / Q000097:blood / Q000175:diagnosis
chemical_list: D016632:Apolipoprotein A-I; D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; C495242:CLU protein, human; D051152:Clusterin; D003176:Complement C3; D010446:Peptide Fragments