title: Serum IGFBP2 and MSLN as diagnostic and prognostic biomarkers for pancreatic cancer.
abstract: BACKGROUND
  Identification of diagnostic and prognostic biomarkers is a research priority for the improved management of pancreatic ductal adenocarcinoma (PDAC). Insulin-like growth factor binding protein 2 (IGFBP2) and mesothelin (MSLN) have shown potential as serum biomarkers in other cancers, but have not been adequately studied in PDAC.
  
  
  METHODS
  Serum IGFBP2 and MSLN levels were quantified by enzyme-linked immunosorbent assay (ELISA) in a cohort of 84 PDAC patients, 84 healthy control subjects and 40 chronic pancreatitis (ChPT) patients. Regression models related IGFBP2 and MSLN levels to diagnosis, gender, age, stage and survival.
  
  
  RESULTS
  IGFPB2 and MSLN serum levels were diagnostic for PDAC in age-adjusted models (P = 0.032 and P = 0.002, respectively) when compared with ChPT and healthy control samples. At a 95% specificity threshold, the sensitivity for IGFBP2 was 22% and the sensitivity for MSLN was 17%. Neither protein approached the diagnostic accuracy of CA 19-9. However, IGFBP2 or MSLN or both correctly identified 18 of the 28 samples misidentified by CA 19-9. In age-adjusted models, neither serum IGFBP2 (P = 0.36) nor MSLN (P = 0.29) were significant predictors of survival.
  
  
  CONCLUSIONS
  Serum IGFBP2 and MSLN are weak diagnostic classifiers individually, but may be useful in a diagnostic biomarker panel.
authors.affiliation: Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA.
authors.forename: Zachary W
authors.initials: ZW
authors.lastname: Kendrick
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Firpo
authors.forename: Robert C
authors.initials: RC
authors.lastname: Repko
authors.forename: Courtney L
authors.initials: CL
authors.lastname: Scaife
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Adler
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Boucher
authors.forename: Sean J
authors.initials: SJ
authors.lastname: Mulvihill
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D021441:Carcinoma, Pancreatic Ductal / Q000097:blood* / Q000401:mortality / Q000473:pathology; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D058851:GPI-Linked Proteins / Q000097:blood*; D006801:Humans; D018971:Insulin-Like Growth Factor Binding Protein 2 / Q000097:blood*; D008297:Male; D000090204:Mesothelin; D008875:Middle Aged; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012307:Risk Factors
chemical_list: D014408:Biomarkers, Tumor; D058851:GPI-Linked Proteins; C577903:IGFBP2 protein, human; D018971:Insulin-Like Growth Factor Binding Protein 2; C000715527:MSLN protein, human; D000090204:Mesothelin