title: Autoantibodies to Ezrin are an early sign of pancreatic cancer in humans and in genetically engineered mouse models.
abstract: BACKGROUND
  Pancreatic Ductal Adenocarcinoma (PDAC) is a highly aggressive malignancy with only a 5% 5-year survival rate. Reliable biomarkers for early detection are still lacking. The goals of this study were (a) to identify early humoral responses in genetically engineered mice (GEM) spontaneously developing PDAC; and (b) to test their diagnostic/predictive value in newly diagnosed PDAC patients and in prediagnostic sera.
  
  
  RESULTS
  The serum reactivity of GEM from inception to invasive cancer, and in resectable or advanced human PDAC was tested by two-dimensional electrophoresis Western blot against proteins from murine and human PDAC cell lines, respectively. A common mouse-to-human autoantibody signature, directed against six antigens identified by MALDI-TOF mass spectrometry, was determined. Of the six antigens, Ezrin displayed the highest frequency of autoantibodies in GEM with early disease and in PDAC patients with resectable disease. The diagnostic value of Ezrin-autoantibodies to discriminate PDAC from controls was further shown by ELISA and ROC analyses (P < 0.0001). This observation was confirmed in prediagnostic sera from the EPIC prospective study in patients who eventually developed PDAC (with a mean time lag of 61.2 months between blood drawing and PDAC diagnosis). A combination of Ezrin-autoantibodies with CA19.9 serum levels and phosphorylated α-Enolase autoantibodies showed an overall diagnostic accuracy of 0.96 ± 0.02.
  
  
  CONCLUSIONS
  Autoantibodies against Ezrin are induced early in PDAC and their combination with other serological markers may provide a predictive and diagnostic signature.
authors.affiliation: Center for Experimental Research and Medical Studies (CeRMS), Azienda Ospedaliera Città della Salute e della Scienza di Torino, Turin, Italy. franco.novelli@unito.it.
authors.forename: Michela
authors.initials: M
authors.lastname: Capello
authors.forename: Paola
authors.initials: P
authors.lastname: Cappello
authors.forename: Federica Caterina
authors.initials: FC
authors.lastname: Linty
authors.forename: Roberto
authors.initials: R
authors.lastname: Chiarle
authors.forename: Isabella
authors.initials: I
authors.lastname: Sperduti
authors.forename: Anna
authors.initials: A
authors.lastname: Novarino
authors.forename: Paola
authors.initials: P
authors.lastname: Salacone
authors.forename: Giorgia
authors.initials: G
authors.lastname: Mandili
authors.forename: Alessio
authors.initials: A
authors.lastname: Naccarati
authors.forename: Carlotta
authors.initials: C
authors.lastname: Sacerdote
authors.forename: Stefania
authors.initials: S
authors.lastname: Beghelli
authors.forename: Samantha
authors.initials: S
authors.lastname: Bersani
authors.forename: Stefano
authors.initials: S
authors.lastname: Barbi
authors.forename: Claudio
authors.initials: C
authors.lastname: Bassi
authors.forename: Aldo
authors.initials: A
authors.lastname: Scarpa
authors.forename: Paola
authors.initials: P
authors.lastname: Nisticò
authors.forename: Mirella
authors.initials: M
authors.lastname: Giovarelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Vineis
authors.forename: Michele
authors.initials: M
authors.lastname: Milella
authors.forename: Francesco
authors.initials: F
authors.lastname: Novelli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001323:Autoantibodies / Q000097:blood / Q000276:immunology*; D021441:Carcinoma, Pancreatic Ductal / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D003430:Cross-Sectional Studies; D003598:Cytoskeletal Proteins / Q000097:blood / Q000276:immunology*; D004195:Disease Models, Animal; D005260:Female; D005818:Genetic Engineering; D006801:Humans; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D008822:Mice, Transgenic; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D011446:Prospective Studies; D000099149:Ezrin
chemical_list: D001323:Autoantibodies; D003598:Cytoskeletal Proteins; D000099149:Ezrin