Using Markers to Improve Pancreatic Cancer Screening

使用标记物改善胰腺癌筛查

• 批准号: 10216185
• 负责人: Michael G. Goggins
• 金额: $ 41.7万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-07-01 至 2025-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10216185
• 关键词: Affect; Aneuploidy; Atrophic; Biological Markers; Blood Tests; CA-125 Antigen; CA-19-9 Antigen; Cancer Etiology; Carboxypeptidase; Cessation of life; Clinical; Clinical Chemistry; Clinical Trials; Data Collection; Databases; Detection; Development; Diagnosis; Diagnostic; Diagnostic Sensitivity; Diagnostic tests; Disease; Early Diagnosis; Evaluation; FDA approved; Fatty acid glycerol esters; Future; Genes; Genetic; Genetic Predisposition to Disease; Genotype; Hyperlipidemia; Image; Individual; Investigation; Lead; Magnetic Resonance Imaging; Malignant Neoplasms; Malignant neoplasm of pancreas; Metabolic syndrome; Monitor; Outcome; Pancreas; Patient-Focused Outcomes; Patients; Performance; Predisposition; Protocols documentation; Reference Values; Resectable; SEER Program; Screening for cancer; Serum; Specificity; Subgroup; Testing; Time; Tumor Burden; Tumor Markers; Validation; Variant; bariatric surgery; base; biobank; biomarker panel; cancer imaging; cancer risk; circulating biomarkers; cohort; cone-beam computed tomography; diagnostic accuracy; diagnostic panel; disorder control; genetic testing; genetic variant; glycosylation; high risk; high risk population; improved; improved outcome; molecular diagnostics; pancreas imaging; pancreatic cancer patients; patient subsets; programs; prospective; screening; surveillance imaging; tumor

Most patients with pancreatic cancer present with advanced incurable disease, but patients diagnosed with Stage I pancreatic cancer have a much better outcome. The early detection of pancreatic cancer requires simple and effective pancreatic screening tests that can be applied to high risk populations. The Cancer of the Pancreas Screening (CAPS) study currently follows a familial/genetic “high-risk” cohort of ~1000 patients undergo regular pancreatic surveillance. Recent results from the CAPS program indicate that pancreatic cancers detected during pancreatic surveillance are down-staged; 40% of those who maintained annual surveillance had a Stage I pancreatic cancer. These results indicate that early detection can improve overall outcome of patients with pancreatic cancer. Circulating tumor marker tests are not currently used for pancreas surveillance. Genetic factors are known to influence tumor marker levels, but gene tests have not been evaluated to determine if they could improve the accuracy of tumor markers. Recent studies from the PI's lab indicate that the normal reference ranges of commonly used tumor markers (CA19-9, CA-125 and CEA) are better defined by an individual's tumor marker genotype. A tumor marker genotype test can improve the diagnostic sensitivity of tumor markers at 99% specificity compared to conventional diagnostic cut-offs. We propose to establish genetically-defined normal reference ranges for tumor marker levels and evaluate their diagnostic accuracy in a prospective clinical trial of patients undergoing pancreatic imaging surveillance through our CAPS program. The addition of annual blood tests to pancreatic surveillance is expected to improve the detection of early-stage pancreatic cancer.

大多数胰腺癌患者都患有晚期无法治愈的疾病，但患者 诊断为 I 期胰腺癌的早期发现效果要好得多。 胰腺癌需要简单有效的胰腺筛查测试 目前正在开展胰腺癌筛查 (CAPS) 研究。 由约 1000 名患者组成的家族/遗传“高风险”队列接受定期胰腺监测。 CAPS 计划的最新结果表明，在 胰腺监测被下调；维持年度监测的人中有 40% I 期胰腺癌这些结果表明早期检测可以整体改善。 目前尚无胰腺癌患者循环肿瘤标志物检测的结果。 用于胰腺监测已知遗传因素会影响肿瘤标志物水平，但 尚未评估基因测试是否可以提高肿瘤的准确性 PI 实验室的最新研究表明，正常参考范围 常用的肿瘤标志物（CA19-9、CA-125 和 CEA）可以根据个人的情况更好地定义 肿瘤标志物基因型检测可以提高肿瘤标志物基因型的诊断敏感性。 与传统诊断临界点相比，我们建议肿瘤标志物的特异性为 99%。 建立基因定义的肿瘤标志物水平正常参考范围并评估其 接受胰腺成像​​的患者的前瞻性临床试验中的诊断准确性 通过我们的 CAPS 计划进行监测 每年进行胰腺血液检查。 监测有望改善早期胰腺癌的检测。