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Exosomal glypican-1 discriminates pancreatic ductal adenocarcinoma from chronic pancreatitis

2021; Elsevier BV; Volume: 54; Issue: 7 Linguagem: Inglês

10.1016/j.dld.2021.10.012

1878-3562

Pedro Moutinho-Ribeiro, Bárbara Adem, Inês A. Batista, Marta Tavares-Silva, Sónia Silva, Carolina F. Ruivo, Rui Morais, Armando Peixoto, Rosa Coelho, Pedro Costa‐Moreira, Susana Lopes, Filipe Vilas‐Boas, Cecília Durães, Joanne Lopes, Helena Barroca, Fátima Carneiro, Sónia A. Melo, Guilherme Macedo,

Phagocytosis and Immune Regulation

Abstract Background and aims Pancreatic ductal adenocarcinoma (PDAC) diagnosis can be difficult in a chronic pancreatitis (CP) background, especially in its mass forming presentation. We aimed to assess the accuracy of glypican-1-positive circulating exosomes (GPC1 + crExos) to distinguish PDAC from CP versus the state-of-the-art CA 19–9 biomarker. Methods This was a unicentric prospective cohort. Endoscopic ultrasound with fine-needle aspiration or biopsy and blood tests (GPC1 + crExos and serum CA 19–9) were performed. Results The cohort comprised 60 PDAC and 29 CP (7 of which mass forming - MF) patients. Median levels of GPC1 + crExos were significantly higher in PDAC (99.7%) versus CP (28.4%; p <0.0001) with an AUROC of 0.96 with 98.3% sensitivity and 86.2% specificity for a cut-off of 45.0% ( p <0.0001); this outperforms CA 19–9 AUROC of 0.82 with 78.3% sensitivity and 65.5% specificity at a cut-off of 37 U/mL ( p <0.0001). The superiority of% GPC1+crExos over CA 19–99 in differentiating PDAC from CP was observed in both early (stage I) and advanced tumors (stages II-IV). Conclusion Levels of GPC1 + crExos coupled to beads enable differential diagnosis between PDAC and CP including its mass-forming presentation.