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Article

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

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Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 6500017, Japan
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Department of Omics Medicine, Hyogo College of Medicine, Hyogo 6638501, Japan
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Department of Gastroenterology, Osaka Saiseikai Nakatsu Hospital, Osaka 5300012, Japan
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Department of Health Care, Yodogawa Christian Hospital, Osaka 5330024, Japan
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Department of Gastroenterology, Kita-harima Medical Center, Hyogo 6751392, Japan
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Department of Health Care, Kyoto Second Red Cross Hospital, Kyoto 6028026, Japan
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Asahara Clinic, Hyogo 6730891, Japan
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Hotel Okura Kobe Clinic, Hyogo 6508560, Japan
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Division of Metabolomics Research, Department of Internal Related, Kobe University Graduate School of Medicine, Hyogo 6500017, Japan
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AMED-CREST, AMED, Tokyo 1000004, Japan
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Department of Biomarkers for the Early Detection of Cancer, National Cancer Center Research Institute, Tokyo 1040045, Japan
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Center for Clinical Research and Advanced Medicine Establishment, Shiga University of Medical Science, Shiga 5202192, Japan
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Research Center for Medical and Health Data Science, The Institute of Statistical Mathematics, Tokyo 1040045, Japan
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Department of Bioregulation, Graduate School of Medicine, Nippon Medical School, Tokyo 1138602, Japan
*
Authors to whom correspondence should be addressed.
Cancers 2020, 12(9), 2625; https://doi.org/10.3390/cancers12092625
Received: 4 July 2020 / Revised: 3 September 2020 / Accepted: 8 September 2020 / Published: 14 September 2020
(This article belongs to the Special Issue Non-Invasive Early Detection of Cancers)
Apolipoprotein A2 isoforms (apoA2-i) have been identified as minimally invasive biomarkers for detecting pancreatic cancer (PC) and high-risk individuals for PC. We investigated the efficiency of an enrichment strategy for high-risk individuals using a combination of blood testing for apoA2-i with imaging examinations in the general population. We enrolled 5120 subjects in experimental pancreatic cancer screening, with 84 subjects (1.3%) showing abnormal results for apoA2-i. Pancreatic diseases were recognized in about 30% of subjects with an apoA2-ATQ/AT level of ≤35 μg/mL. Among them, 1 pancreatic cancer and 15 high-risk individuals with intraductal papillary mucinous neoplasm were detected. ApoA2-i has the potential to enrich PC and high-risk status by increasing the diagnostic probability before imaging examinations.
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. View Full-Text
Keywords: pancreatic cancer; biomarker; cancer screening; apoA2 isoforms pancreatic cancer; biomarker; cancer screening; apoA2 isoforms
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Figure 1

MDPI and ACS Style

Sato, Y.; Kobayashi, T.; Nishiumi, S.; Okada, A.; Fujita, T.; Sanuki, T.; Kobayashi, M.; Asahara, M.; Adachi, M.; Sakai, A.; Shiomi, H.; Masuda, A.; Yoshida, M.; Takeuchi, K.; Kodama, Y.; Kutsumi, H.; Nagashima, K.; Honda, K. Prospective Study Using Plasma Apolipoprotein A2-Isoforms to Screen for High-Risk Status of Pancreatic Cancer. Cancers 2020, 12, 2625. https://doi.org/10.3390/cancers12092625

AMA Style

Sato Y, Kobayashi T, Nishiumi S, Okada A, Fujita T, Sanuki T, Kobayashi M, Asahara M, Adachi M, Sakai A, Shiomi H, Masuda A, Yoshida M, Takeuchi K, Kodama Y, Kutsumi H, Nagashima K, Honda K. Prospective Study Using Plasma Apolipoprotein A2-Isoforms to Screen for High-Risk Status of Pancreatic Cancer. Cancers. 2020; 12(9):2625. https://doi.org/10.3390/cancers12092625

Chicago/Turabian Style

Sato, Yu, 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, and Kazufumi Honda. 2020. "Prospective Study Using Plasma Apolipoprotein A2-Isoforms to Screen for High-Risk Status of Pancreatic Cancer" Cancers 12, no. 9: 2625. https://doi.org/10.3390/cancers12092625

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