Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] · 2025
Establishment of simple pancreatic ductal adenocarcinoma identification method: S100P measurement in duodenal fluid obtained during upper gastrointestinal endoscopy.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Ideno Noboru, Hanada Keiji, Tokunaga Shoji, Ohtsuka Takao, Mori Yasuhisa, Hara Kazuo, Katanuma Akio, Kitano Masayuki, Fukasawa Mitsuharu, So Suketo, Sudo Kentaro, Aoyagi Kunihiko, Takenaka Mamoru, Hashimoto Shinichi, Ohuchida Kenoki, Tanaka Masao, Nakamura Masafumi
Аннотация
BACKGROUND AND AIMS: Establishing an effective screening method for pancreatic ductal adenocarcinoma (PDAC) is important. This study re-evaluated the diagnostic utility of the duodenal fluid (DF) marker S100 calcium-binding protein P (S100P) during upper gastrointestinal endoscopy (GIE).
METHODS: Study 1 and Study 2 prospectively enrolled 173 and 36 patients with PDACs, and 237 and 80 controls, respectively. All subjects underwent upper GIE, endoscopic ultrasonography, or endoscopic retrograde cholangiopancreatography at 10 Japanese institutions in Study 1 versus three in Study 2. DF was collected without secretin stimulation, and S100P concentrations were measured. Study 1 identified two potential factors that significantly affected the S100P levels; thus, the sample collection protocol for Study 2 eliminated them.
RESULTS: S100P levels differed significantly between patients with PDAC and controls in Study 1 (median 39.80 ng/ml versus 15.50 ng/ml, respectively; p < 0.001). The area under the receiver operating characteristics curve (AUC) comparing S100P levels between patients with PDAC and controls was 0.642 (95 % confidence interval, 0.584-0.694). Higher values were obtained with trans-nasal endoscopy and immediate storage at -80 °C versus no immediate freezing. In Study 2, S100P levels were significantly higher in the patients with PDAC versus controls (median 33.40 ng/ml versus 5.00 ng/ml, respectively; p < 0.0001). The AUC comparing S100P levels among all 34 patients with PDAC and 76 controls was 0.851 (95 % confidence interval, 0.766-0.921).
CONCLUSIONS: This study demonstrated the utility of the S100P in DF analysis for the early diagnosis of PDAC and clarified potential issues related to sample collections in the actual clinical settings.
METHODS: Study 1 and Study 2 prospectively enrolled 173 and 36 patients with PDACs, and 237 and 80 controls, respectively. All subjects underwent upper GIE, endoscopic ultrasonography, or endoscopic retrograde cholangiopancreatography at 10 Japanese institutions in Study 1 versus three in Study 2. DF was collected without secretin stimulation, and S100P concentrations were measured. Study 1 identified two potential factors that significantly affected the S100P levels; thus, the sample collection protocol for Study 2 eliminated them.
RESULTS: S100P levels differed significantly between patients with PDAC and controls in Study 1 (median 39.80 ng/ml versus 15.50 ng/ml, respectively; p < 0.001). The area under the receiver operating characteristics curve (AUC) comparing S100P levels between patients with PDAC and controls was 0.642 (95 % confidence interval, 0.584-0.694). Higher values were obtained with trans-nasal endoscopy and immediate storage at -80 °C versus no immediate freezing. In Study 2, S100P levels were significantly higher in the patients with PDAC versus controls (median 33.40 ng/ml versus 5.00 ng/ml, respectively; p < 0.0001). The AUC comparing S100P levels among all 34 patients with PDAC and 76 controls was 0.851 (95 % confidence interval, 0.766-0.921).
CONCLUSIONS: This study demonstrated the utility of the S100P in DF analysis for the early diagnosis of PDAC and clarified potential issues related to sample collections in the actual clinical settings.