A multiplex serum biochip allows screening for pancreatic cancer at early tumor stages

BACKGROUND-AIM Pancreatic cancer is one of the most lethal malignancies worldwide. Detection of pancreatic cancer at early stages is crucial because successful surgery at early tumour stages is the only curative therapy today. The persistent delay in diagnosis and the associated high mortality are attributable to the lack of symptoms at early tumour stages combined with a high biological aggressiveness of the tumour and limited treatment options. Therefore, improved screening for earlier diagnosis is essential in order to increase the rate of curatively resectable carcinomas thereby ameliorating patients' prognosis. A relatively non-invasive, cost-efficient possibility could be provided by the measurement of disease specific markers in peripheral blood. This study reports a novel biochip array for the multiplex detection of the serum proteins carcinoembryonic antigen (CEA), interleukin-8 (IL-8), vascular endothelial growth factor (VEGF), macrophage colony-stimulating factor (M-CSF), S100A11, C3adesArg, CD26 and C-reactive protein (CRP) and its application to the screening of pancreatic cancer at early stages. METHODS Simultaneous chemiluminescent immunoassays, defining discrete test sites on a biochip surface were employed. Highly standardized preserved serum samples (n=201) reflecting healthy controls, pancreatic adenomas, and pancreatic carcinomas were assessed with this methodology. RESULTS Serum levels of CEA, VEGF, S100A11, MCSF, CD26, and CRP showed significant differences between cancer cases and controls. An independent quartile-based predictive model showed a clinical performance for detecting pancreatic carcinomas using a combination of MCS-F, S100A11, C3adesArg and CD26 with 70% sensitivity at 90% specificity (AUC = 0.9015). At 90% specificity, even early carcinomas were detected with 69% sensitivity. CONCLUSION CEA, VEGF, S100A11, MCSF, CD26, and CRP show a high potential for early detection of pancreatic cancer, and could thus aid early detection for curative treatment in a clinical setting.