Potentials of Plasma NGAL and MIC-1 as Biomarker(s) in the Diagnosis of Lethal Pancreatic Cancer

Sukwinder Kaur, Subhankar Chakraborty, Michael J. Baine, Kavita Mallya, Lynette M Smith, Aaron Sasson, Randall Brand, Sushovan Guha, Maneesh Jain, Uwe Wittel, Shailender Singh, Surinder Kumar Batra

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Abstract

Pancreatic cancer (PC) is lethal malignancy with very high mortality rate. Absence of sensitive and specific marker(s) is one of the major factors for poor prognosis of PC patients. In pilot studies using small set of patients, secreted acute phase proteins neutrophil gelatinase associated lipocalin (NGAL) and TGF-β family member macrophage inhibitory cytokine-1 (MIC-1) are proposed as most potential biomarkers specifically elevated in the blood of PC patients. However, their performance as diagnostic markers for PC, particularly in pre-treatment patients, remains unknown. In order to evaluate the diagnostic efficacy of NGAL and MIC-1, their levels were measured in plasma samples from patients with pre-treatment PC patients (n = 91) and compared it with those in healthy control (HC) individuals (n = 24) and patients with chronic pancreatitis (CP, n = 23). The diagnostic performance of these two proteins was further compared with that of CA19-9, a tumor marker commonly used to follow PC progression. The levels of all three biomarkers were significantly higher in PC compared to HCs. The mean (± standard deviation, SD) plasma NGAL, CA19-9 and MIC-1 levels in PC patients was 111.1 ng/mL (2.2), 219.2 U/mL (7.8) and 4.5 ng/mL (4.1), respectively. In comparing resectable PC to healthy patients, all three biomarkers were found to have comparable sensitivities (between 64%-81%) but CA19-9 and NGAL had a higher specificity (92% and 88%, respectively). For distinguishing resectable PC from CP patients, CA19-9 and MIC-1 were most specific (74% and 78% respectively). CA19-9 at an optimal cut-off of 54.1 U/ml is highly specific in differentiating resectable (stage 1/2) pancreatic cancer patients from controls in comparison to its clinical cut-off (37.1 U/ml). Notably, the addition of MIC-1 to CA19-9 significantly improved the ability to distinguish resectable PC cases from CP (p = 0.029). Overall, MIC-1 in combination with CA19-9 improved the diagnostic accuracy of differentiating PC from CP and HCs.

Original languageEnglish (US)
Article numbere55171
JournalPloS one
Volume8
Issue number2
DOIs
StatePublished - Feb 1 2013

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Growth Differentiation Factor 15
Lipocalins
pancreatic neoplasms
Gelatinases
Biomarkers
Pancreatic Neoplasms
neutrophils
biomarkers
macrophages
cytokines
Plasmas
Patient treatment
Acute-Phase Proteins
Tumor Biomarkers
Lipocalin-2
Blood
pretreatment
pancreatitis
acute phase proteins
Chronic Pancreatitis

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Potentials of Plasma NGAL and MIC-1 as Biomarker(s) in the Diagnosis of Lethal Pancreatic Cancer. / Kaur, Sukwinder; Chakraborty, Subhankar; Baine, Michael J.; Mallya, Kavita; Smith, Lynette M; Sasson, Aaron; Brand, Randall; Guha, Sushovan; Jain, Maneesh; Wittel, Uwe; Singh, Shailender; Batra, Surinder Kumar.

In: PloS one, Vol. 8, No. 2, e55171, 01.02.2013.

Research output: Contribution to journalArticle

Kaur, Sukwinder ; Chakraborty, Subhankar ; Baine, Michael J. ; Mallya, Kavita ; Smith, Lynette M ; Sasson, Aaron ; Brand, Randall ; Guha, Sushovan ; Jain, Maneesh ; Wittel, Uwe ; Singh, Shailender ; Batra, Surinder Kumar. / Potentials of Plasma NGAL and MIC-1 as Biomarker(s) in the Diagnosis of Lethal Pancreatic Cancer. In: PloS one. 2013 ; Vol. 8, No. 2.
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AU - Sasson, Aaron

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AU - Guha, Sushovan

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