Combining conventional and stroma-derived tumour markers in pancreatic ductal adenocarcinoma

Article type: Research Article

Authors: Franklin, Oskar^{a; 1} | Öhlund, Daniel^{a; 1} | Lundin, Christina^a | Öman, Mikael^a | Naredi, Peter^a | Wang, Wanzhong^b | Sund, Malin^{a; *}

Affiliations: [a] Department of Surgical and Perioperative Sciences, Umeå, Sweden | [b] Department of Pathology, Umeå University, Umeå, Sweden

Correspondence: [*] Corresponding author: Malin Sund, Department of Surgical and Perioperative Sciences, Umeå University, SE-901 85 Umeå, Sweden. Tel.: +46 90 785 00 00; Fax: +46 90 785 11 56; E-mail: malin.sund@surgery.umu.se.

Note: [1] These authors contributed equally to this work.

Abstract: Background:A lack of disease-specific symptoms and good tumour markers makes early detection and diagnosis of pancreatic ductal adenocarcinoma (PDAC) challenging. Objective:To analyse the tissue expression and circulating levels of four stroma-derived substances (type IV collagen, endostatin/type XVIII collagen, osteopontin and tenascin C) and four conventional tumour markers (CA 19-9, TPS, CEA and Ca 125) in a PDAC cohort. Methods:Tissue expression of markers in normal pancreas and PDAC tissue was analysed with immunofluorescence. Plasma concentrations of markers were measured before and after surgery. Patients with non-malignant disorders served as controls. Results:The conventional and stromal substances were expressed in the cancer cell compartment and the stroma, respectively. Although most patients had increased levels of many markers before surgery, 2/12 (17%) of patients had normal levels of Ca 19-9 at this stage. High preoperative endostatin/type XVIII collagen, and postoperative type IV collagen was associated with short survival. Neither the pre- nor postoperative levels of TPS, Ca 125 or CA 19-9 were associated to survival. Conclusions:PDAC is characterized by an abundant stroma. These initial observations indicate that the stroma can be a source of PDAC tumour markers that are found in different compartments of the cancer, thus reflecting different aspects of tumour biology.

Keywords: Pancreatic ductal adenocarcinoma (PDAC), tumour markers, stroma, type IV collagen, type XVIII collagen, endostatin, osteopontin, tenascin C, TPS, Ca 125, Ca 19-9, CEA

DOI: 10.3233/CBM-140430

Journal: Cancer Biomarkers, vol. 15, no. 1, pp. 1-10, 2015