Document Detail


Neutrophil gelatinase-associated lipocalin, macrophage inhibitory cytokine 1, and carbohydrate antigen 19-9 in pancreatic juice: pathobiologic implications in diagnosing benign and malignant disease of the pancreas.
MedLine Citation:
PMID:  23146921     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Pancreatic diseases pose significant diagnostic challenge as signs and symptoms often overlap. We investigated the potential of pancreatic juice neutrophil gelatinase-associated lipocalin, macrophage inhibitory cytokine 1 (MIC-1), and carbohydrate antigen 19-9 (CA19-9) to aid in the diagnosis of patients with symptoms suggestive of pancreatic diseases.
METHODS: A total of 105 chronic pancreatitis (CP), pancreatic cancer (PC), and nonpancreatic nonhealthy (patients with symptoms mimicking pancreatic disease but found to be free of any pancreatic disease) patients underwent endoscopic pancreatic juice collection after secretin stimulation. Neutrophil gelatinase-associated lipocalin and MIC-1 levels were measured by enzyme-linked immunosorbent assay, whereas CA19-9 was measured by radioimmunoassay.
RESULTS: Neutrophil gelatinase-associated lipocalin, MIC-1, and CA19-9 were significantly elevated in the pancreatic juice of patients with CP and patients with PC as compared with nonpancreatic nonhealthy controls (P ≤ 0.034). Neutrophil gelatinase-associated lipocalin seemed most promising in differentiating diseased versus nondiseased pancreata (areas under the curve, 0.88-0.91), whereas MIC-1 was found to be higher in patients with PC than in patients with CP (P = 0.043). Interestingly, MIC-1 levels in diabetic patients with PC were higher than in nondiabetic patients with PC (P = 0.030) and diabetic patients with CP (P = 0.087). Carbohydrate antigen 19-9 showed the least ability to distinguish patient groups (areas under the curve, 0.61-0.76).
CONCLUSIONS: Pancreatic juice neutrophil gelatinase-associated lipocalin shows potential utility in establishing pancreatic etiology in the context of nonspecific symptoms, whereas MIC-1 may aid in differentiating PC from CP.
Authors:
Sukhwinder Kaur; Michael J Baine; Sushovan Guha; Nobuo Ochi; Subhankar Chakraborty; Kavita Mallya; Colleen Thomas; Julia Crook; Michael B Wallace; Timothy A Woodward; Maneesh Jain; Shailender Singh; Aaron R Sasson; Verna Skinner; Massimo Raimondo; Surinder K Batra
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pancreas     Volume:  42     ISSN:  1536-4828     ISO Abbreviation:  Pancreas     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-15     Completed Date:  2013-08-30     Revised Date:  2014-04-02    
Medline Journal Info:
Nlm Unique ID:  8608542     Medline TA:  Pancreas     Country:  United States    
Other Details:
Languages:  eng     Pagination:  494-501     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Acute-Phase Proteins / metabolism*
Aged
Biological Markers / metabolism
CA-19-9 Antigen / metabolism*
Diabetes Mellitus, Type 2 / complications,  metabolism
Diagnosis, Differential
Enzyme-Linked Immunosorbent Assay
Female
Growth Differentiation Factor 15 / metabolism*
Humans
Lipocalins / metabolism*
Male
Middle Aged
Pancreas / metabolism,  pathology
Pancreatic Juice / metabolism*
Pancreatic Neoplasms / complications,  diagnosis,  metabolism
Pancreatitis, Chronic / complications,  diagnosis,  metabolism
Prospective Studies
Proto-Oncogene Proteins / metabolism*
Radioimmunoassay
Sensitivity and Specificity
Grant Support
ID/Acronym/Agency:
P50 CA127297/CA/NCI NIH HHS; P50 CA127297/CA/NCI NIH HHS; R01 CA131944/CA/NCI NIH HHS; R01 CA131944/CA/NCI NIH HHS; U01 CA111294/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Acute-Phase Proteins; 0/Biological Markers; 0/CA-19-9 Antigen; 0/Growth Differentiation Factor 15; 0/LCN2 protein, human; 0/Lipocalins; 0/Proto-Oncogene Proteins
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