Cancers (Sep 2020)

Prospective Study Using Plasma Apolipoprotein A2-Isoforms to Screen for High-Risk Status of Pancreatic Cancer

  • Yu Sato,
  • Takashi Kobayashi,
  • Shin Nishiumi,
  • Akihiko Okada,
  • Tsuyoshi Fujita,
  • Tsuyoshi Sanuki,
  • Masao Kobayashi,
  • Masakyo Asahara,
  • Masayasu Adachi,
  • Arata Sakai,
  • Hideyuki Shiomi,
  • Atsuhiro Masuda,
  • Masaru Yoshida,
  • Keiko Takeuchi,
  • Yuzo Kodama,
  • Hiromu Kutsumi,
  • Kengo Nagashima,
  • Kazufumi Honda

DOI
https://doi.org/10.3390/cancers12092625
Journal volume & issue
Vol. 12, no. 9
p. 2625

Abstract

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Apolipoprotein A2-ATQ/AT (apoA2-ATQ/AT) has been identified as a minimally invasive biomarker for detecting pancreatic cancer (PC) and high-risk (HR) individuals for PC. To establish an efficient enrichment strategy for HR, we carried out a plasma apoA2-ATQ/AT level-based prospective screening study among the general population. The subjects for the screening study were recruited at six medical check-up facilities in Japan between October 2015 and January 2017. We evaluated the positive predictive value (PPV) of the plasma apoA2-ATQ/AT level of ≤35 μg/mL for detecting PC and HR. Furthermore, we prospectively confirmed its diagnostic accuracy with another post-diagnosis population in a cross-sectional study. We enrolled 5120 subjects in experimental screening, with 84 subjects (1.3%) showing positive results for apoA2-ATQ/AT. Pancreatic abnormalities were recognized in 26 of the 84 subjects from imaging examinations. Pancreatic abnormalities detected included 1 PC and 15 HR abnormalities, such as cystic lesions including intraductal papillary mucinous neoplasm. The PPV of apoA2-ATQ/AT for detecting PC and HR was 33.3%. Moreover, a combination study with another cross-sectional study revealed that the area under the curve for apoA2-ATQ/AT to distinguish PC from healthy controls was 0.903. ApoA2-ATQ/AT has the potential to enrich PC and HR by increasing the diagnostic probability before imaging examinations.

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