20026-01-30 アメリカ国立衛生研究所(NIH)
<関連情報>
- https://www.nih.gov/news-events/news-releases/researchers-identify-new-blood-markers-may-detect-early-pancreatic-cancer
- https://aacrjournals.org/clincancerres/article-abstract/doi/10.1158/1078-0432.CCR-25-3297/771953/Improving-a-Plasma-Biomarker-Panel-for-Early?redirectedFrom=fulltext
アミノペプチダーゼN(ANPEP)とポリマー免疫グロブリン受容体(PIGR)を用いた膵管腺癌の早期発見のための血漿バイオマーカーパネルの改善 Improving a Plasma Biomarker Panel for Early Detection of Pancreatic Ductal Adenocarcinoma with Aminopeptidase N (ANPEP) and Polymeric Immunoglobulin Receptor (PIGR)
Brianna M. Krusen;Phyllis A. Gimotty;Greg Donahue;Jacob E. Till;Melinda Yin;Erin E. Carlson;William R. Bamlet;Erica L. Carpenter;Shounak Majumder;Ann L. Oberg;Kenneth S. Zaret
Clinical Cancer Research Published:January 28 2026
DOI:https://doi.org/10.1158/1078-0432.CCR-25-3297
Abstract
Purpose:
Pancreatic ductal adenocarcinoma (PDAC) is typically detected too late for useful therapeutic interventions; hence, we sought blood biomarkers to detect early-stage disease.
Experimental Design:
Using mass spectrometry and ELISA on plasma pools from the University of Pennsylvania (Penn) and the Mayo Clinic (Mayo), we identified aminopeptidase N (ANPEP) and polymeric immunoglobulin receptor (PIGR) as increased in early-stage (stage I/II) PDAC plasma compared with controls. We tested ANPEP and PIGR, along with prior data for thrombospondin 2 (THBS2) and carbohydrate antigen 19-9 (CA19-9), in retrospective phase II studies using separate cohorts of PDAC plasmas at different stages versus healthy or nonmalignant disease controls (DC) from Penn (n = 135) and Mayo (n = 537).
Results:
Comparing healthy controls with stage I/II PDAC, we obtained area under the receiver-operating characteristic curves (AUC) of 0.78 [95% confidence interval (CI), 0.68–0.86]/0.80 (95% CI, 0.74–0.85; ANPEP) and 0.81 (95% CI, 0.70–0.88)/0.86 (95% CI, 0.82–0.90; PIGR) for the Penn/Mayo phase II studies, respectively. In multivariable models, CA19-9/THBS2/ANPEP, CA19-9/THBS2/PIGR, and CA19-9/THBS2/ANPEP/PIGR elicited AUC of 0.94 to 0.96 for Penn and 0.97 for Mayo. Notably, the four-marker panel elicited AUC of 0.87 for the Mayo stage I/II versus DC and 0.91 for stages I to IV versus DC. At a specificity of 95%, a plasma biomarker panel composed of CA19-9 (≥35 U/mL), THBS2 (≥42 ng/mL), ANPEP (≥2,995 ng/mL), and PIGR (≥1,800 ng/mL) yielded a sensitivity of 91.9% for PDAC stages I to IV and 87.5% for PDAC stage I/II.
Conclusions:
Adding ANPEP and PIGR to a plasma biomarker panel of CA19-9 and THBS2 enhances the detection of early-stage PDAC when comparing cancer versus healthy or nonmalignant DC. Given the concordance of our data in two retrospective phase II studies, assessments in prediagnostic cases are warranted.
