title: Differential Diagnosis of Autoimmune Pancreatitis From Pancreatic Cancer by Analysis of Serum Gelatinase Levels.
abstract: The aim of this study was to analyze serum gelatinases as part of the clinical strategy for the preoperative differentiation between autoimmune pancreatitis (AIP) and pancreatic ductal adenocarcinoma (PDAC). The finding of differential markers will prevent unnecessary surgical resection and allow optimal treatment of these diseases.
  
  
  
  Quantitative gelatin zymography was applied to analyze all individual gelatinase forms in serum and to define proteinase alterations associated with AIP and PDAC. For this purpose, sera of 130 patients, being 29 with AIP, 33 with chronic pancreatitis, 32 with PDAC, and 36 healthy controls, were first assayed for gelatinase levels by quantitative zymography before further validation by the analysis with commercial sandwich enzyme linked immunosorbent assays.
  
  
  
  Serum profiling data obtained by zymography analysis revealed that gelatinase B/matrix metalloproteinase 9 (MMP-9), the neutrophil gelatinase B-associated lipocalin/MMP-9 complex, and gelatinase A/MMP-2 levels were significantly increased in patients with AIP. These proteins are promising markers to discriminate between AIP and PDAC. The best composite parameter, being the ratio of total MMP-9 over MMP-2 levels, can predict 93% of the AIP and 75% of the PDAC correctly. With enzyme linked immunosorbent assay, we confirmed the zymography results.
  
  
  
  Differential gelatinase serum profiles as AIP markers, together with other clinical tests, help to assure the diagnosis of PDAC or AIP.
authors.affiliation: From the *Department of General Surgery and †Institute of Pathology, University of Heidelberg, Heidelberg; and ‡Department of General, Visceral, Transplantations, Vascular and Thorax Surgery, LMU Munich, Munich, Germany; and §Department of Microbiology and Immunology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium.
authors.forename: Klaus
authors.initials: K
authors.lastname: Felix
authors.forename: Sophie
authors.initials: S
authors.lastname: Dobiasch
authors.forename: Matthias M
authors.initials: MM
authors.lastname: Gaida
authors.forename: Kathrin
authors.initials: K
authors.lastname: Schneider
authors.forename: Jens
authors.initials: J
authors.lastname: Werner
authors.forename: Erik
authors.initials: E
authors.lastname: Martens
authors.forename: Jennifer
authors.initials: J
authors.lastname: Vandooren
authors.forename: Ghislain
authors.initials: G
authors.lastname: Opdenakker
mesh_terms: D000328:Adult; D000368:Aged; D001327:Autoimmune Diseases / Q000097:blood / Q000175:diagnosis* / Q000201:enzymology; D015415:Biomarkers / Q000097:blood / Q000378:metabolism*; D021441:Carcinoma, Pancreatic Ductal / Q000097:blood / Q000175:diagnosis* / Q000201:enzymology; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D018093:Gelatinases / Q000097:blood / Q000378:metabolism*; D006801:Humans; D000071068:Lipocalin-2 / Q000097:blood / Q000378:metabolism; D008297:Male; D020778:Matrix Metalloproteinase 2 / Q000097:blood / Q000378:metabolism; D020780:Matrix Metalloproteinase 9 / Q000097:blood / Q000378:metabolism; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000201:enzymology; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis* / Q000201:enzymology; D012372:ROC Curve
chemical_list: D015415:Biomarkers; D000071068:Lipocalin-2; D018093:Gelatinases; D020778:Matrix Metalloproteinase 2; D020780:Matrix Metalloproteinase 9