title: Combined detection of serum UL16-binding protein 2 and macrophage inhibitory cytokine-1 improves early diagnosis and prognostic prediction of pancreatic cancer.
abstract: Pancreatic cancer (PC) is the fourth leading cause of cancer-related mortality in the United States. There is no effective serum biomarker for the early diagnosis of PC at present. Although serum UL16-binding protein 2 (ULBP2) and macrophage inhibitory cytokine-1 (MIC-1) levels are reported to be elevated in PC patients, the diagnostic and prognostic value of ULBP2 and MIC-1 alone or in combination remains unknown. The aim of the present case-control study was to compare the diagnostic value of ULBP2, MIC-1 and carbohydrate antigen 19-9 (CA19-9) in 359 serum samples, consisting of 152 cases of PC, 20 cases of pre-pancreatic cancer, 91 cases of chronic pancreatitis (CP) and 96 normal controls (NC). All patients were followed up for a median of 2 years. It was found that the serum levels of ULBP2, MIC-1 and CA19-9 were significantly higher in the PC patients compared with those in the NC group. In distinguishing PC from the CP, the highest sensitivity and specificity were ULBP2 (0.878) and CA19-9 (0.816), respectively. The area under the receiver operating characteristic curve of ULBP2 was 0.923, which was the highest of the three biomarkers. MIC-1 was the optimal choice for the diagnosis of early-stage PC (area under the curve, 0.831). Overall, MIC-1 in combination with ULBP2 improved the diagnostic accuracy in differentiating PC from CP and NC. In addition, a higher level of MIC-1 was correlated with a poorer prognosis, as calculated by the Kaplan-Meier test (P=0.039). Patients with serum MIC-1 levels of ≥1,932 ng/ml had a median survival time of 15.62±2.44 months (mean ± standard deviation) vs. 18.66±2.43 months in patients with a lower level of MIC-1. Overall, combined detection of serum MIC-1 and ULBP2 improved the diagnostic accuracy in differentiating PC from CP and NC, and serum MIC-1 level alone was a predictor of survival in the patients with PC.
authors.affiliation: Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China.
authors.forename: Yu-Fen
authors.initials: YF
authors.lastname: Zhou
authors.affiliation: Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China.
authors.forename: Ling-Xiao
authors.initials: LX
authors.lastname: Xu
authors.affiliation: Department of Gastroenterology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, P.R. China.
authors.forename: Li-Ya
authors.initials: LY
authors.lastname: Huang
authors.affiliation: Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China.
authors.forename: Fang
authors.initials: F
authors.lastname: Guo
authors.affiliation: Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China.
authors.forename: Fan
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China.
authors.forename: Xiang-Yi
authors.initials: XY
authors.lastname: He
authors.affiliation: Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China.
authors.forename: Yao-Zong
authors.initials: YZ
authors.lastname: Yuan
authors.affiliation: Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China.
authors.forename: Wei-Yan
authors.initials: WY
authors.lastname: Yao
keywords: UL16-binding protein 2; macrophage inhibitory cytokine-1; pancreatic cancer; serum biomarker