Caba O, Diéguez-Castillo C, Martínez-Galán J, González-Cebrián I, Jiménez-Luna C. Serum biomarkers for the differentiation of autoimmune pancreatitis from pancreatic ductal adenocarcinoma. World J Gastrointest Oncol 2023; 15(2): 268-275 [PMID: 36908319 DOI: 10.4251/wjgo.v15.i2.268]
Corresponding Author of This Article
Carmelo Diéguez-Castillo, MD, PhD, Research Scientist, Department of Gastroenterology, San Cecilio University Hospital, Avenida del Conocimiento, s/n, Granada 18016, Spain. carmelo89dc@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Octavio Caba, Cristina Jiménez-Luna, Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, Granada 18016, Spain
Octavio Caba, Cristina Jiménez-Luna, Biosanitary Institute of Granada (ibs.GRANADA), 18014 Granada, Spain
Carmelo Diéguez-Castillo, Department of Gastroenterology, San Cecilio University Hospital, Granada 18016, Spain
Joaquina Martínez-Galán, Department of Medical Oncology, Virgen de las Nieves University Hospital, Granada 18014, Spain. Biosanitary Institute of Granada (ibs.GRANADA), 18014 Granada, Spain
Irene González-Cebrián, Department of Digestive Cancer, San Cecilio University Hospital, Granada 18016, Spain
Author contributions: Caba O designed the overall concept and outline of the manuscript; Diéguez-Castillo C, Martínez-Galán J, and González-Cebrián I contributed to the discussion, and carried out the design of the manuscript; Diéguez-Castillo C and Jiménez-Luna C contributed to the writing and editing of the manuscript and review of the literature.
Supported byFondos Feder, No. A-CTS-436-UGR20.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Carmelo Diéguez-Castillo, MD, PhD, Research Scientist, Department of Gastroenterology, San Cecilio University Hospital, Avenida del Conocimiento, s/n, Granada 18016, Spain. carmelo89dc@gmail.com
Received: September 20, 2022 Peer-review started: September 20, 2022 First decision: November 15, 2022 Revised: November 29, 2022 Accepted: January 17, 2023 Article in press: January 17, 2023 Published online: February 15, 2023
Abstract
Autoimmune pancreatitis (AIP), a chronic inflammation caused by the immune system attacking the pancreas, usually presents imaging and clinical features that overlap with those of pancreatic ductal adenocarcinoma (PDAC). Serum biomarkers, substances that quantitatively change in sera during disease development, are a promising non-invasive tool with high utility for differentiating between these diseases. In this way, the presence of AIP is currently suspected when serum concentrations of immunoglobulin G4 (IgG4) antibody are elevated. However, this approach has some drawbacks. Notably, IgG4 antibody concentrations are also elevated in sera from some patients with PDAC. This review focuses on the most recent and relevant serum biomarkers proposed to differentiate between AIP and PDAC, evaluating the usefulness of immunoglobulins, autoantibodies, chemokines, and cytokines. The proposed serum biomarkers have proven useful, although most studies had a small sample size, did not examine their presence in patients with PDAC, or did not test them in humans. In addition, current evidence suggests that a single serum biomarker is unlikely to accurately differentiate these diseases and that a set of biomarkers will be needed to achieve adequate specificity and sensitivity, either alone or in combination with clinical data and/or radiological images.
Core Tip: The imaging and clinical features of autoimmune pancreatitis commonly overlap with those of pancreatic ductal adenocarcinoma. This study reviews the most recent and relevant serum biomarkers proposed to differentiate between these diseases of the pancreas, including serum immunoglobulins, autoantibodies, chemokines, and cytokines, evaluating their usefulness for this purpose. One of the key conclusions is that a panel of various serum biomarkers appears to be necessary for an accurate differentiation between these diseases, either alone or in combination with clinical data and/or radiological images. Importantly, further research is warranted to assess the usefulness of these promising serum biomarkers in clinical practice
