A combination of three proteins found at high levels in urine can accurately detect early-stage pancreatic cancer, researchers at the BCI have shown. The discovery could lead to a non-invasive, inexpensive test to screen people at high risk of developing the disease.
Dr Tatjana Crnogorac-Jurcevic’s group has shown that the three-protein ‘signature’ can both identify the most common form of pancreatic cancer when still in its early stages – and distinguish between this cancer and the inflammatory condition chronic pancreatitis, which can be hard to tell apart.
The study 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, with approximately half being common to both male and female volunteers. Of these, 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.
The five-year survival rate for pancreatic cancer is the lowest of any common cancer, standing at 3 per cent. This figure has barely improved in 40 years. There is no early diagnostic test available.
Lead researcher, Dr Tatjana Crnogorac-Jurcevic, said: “We’ve always been keen to develop a diagnostic test in urine as it has several advantages over using blood. It’s an inert and far less complex fluid than blood and can be repeatedly and non-invasively tested. It took a while to secure proof of principle funding in 2008 to look at biomarkers in urine, but it’s been worth the wait for these results. 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.” Barts Cancer Institute