London: A combination of three proteins found at high levels in urine can accurately detect early-stage pancreatic cancer, scientists say, which could lead to a non-invasive, inexpensive test for the disease. Researchers have shown that the three-protein ‘signature’ can identify the most common form of pancreatic cancer in its early stages. It can also distinguish between this cancer and the inflammatory condition chronic pancreatitis, which can be hard to tell apart.
The researchers looked at 488 urine samples – 192 from patients known to have pancreatic cancer, 92 from patients with chronic pancreatitis and 87 from healthy volunteers. A further 117 samples from patients with other benign and malignant liver and gall bladder conditions were used for further validation. Around 1500 proteins were found in the urine samples, of which three proteins – LYVE1, REG1A and TFF1 – were selected for closer examination, based on biological information and performance in statistical analysis.
Patients with pancreatic cancer were found to have increased levels of each of the three proteins when compared to urine samples from healthy patients, while patients suffering from chronic pancreatitis had significantly lower levels than cancer patients. When combined, the three proteins formed a robust panel that can detect patients with stages I-II pancreatic cancer with over 90 per cent accuracy. With few specific symptoms even at a later stage of the disease, more than 80 per cent of people with pancreatic cancer are diagnosed when the cancer has already spread. This means they are not eligible for surgery to remove the tumour – currently the only potentially curative treatment.
“We’ve always been keen to develop a diagnostic test in urine as it has several advantages over using blood,” said lead researcher Tatjana Crnogorac-Jurcevic of Queen Mary University of London. “This is a biomarker panel with good specificity and sensitivity and we’re hopeful that a simple, inexpensive test can be developed and be in clinical use within the next few years,” Crnogorac-Jurcevic said. Crnogorac-Jurcevic now wants to examine urine samples collected from volunteers over a period of 5-10 years, who went on to develop pancreatic cancer. This information will allow the researchers to see if the 3-biomarker signature is present during the time between the genetic changes that will cause the cancer to develop and the clinical presentation. The study was published in the journal Clinical Cancer Research.