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World J Clin Oncol. Jun 10, 2017; 8(3): 255-260
Published online Jun 10, 2017. doi: 10.5306/wjco.v8.i3.255
Potential prognostic biomarkers in pancreatic juice of resectable pancreatic ductal adenocarcinoma
Shefali Agrawal
Shefali Agrawal, Hepatobiliary and Pancreatic Surgery, Department of Surgical Oncology, Indraprastha Apollo Hospitals, New Delhi 110076, India
Author contributions: Agrawal S solely contributed to this paper.
Conflict-of-interest statement: None.
Open-Access: 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/
Correspondence to: Shefali Agrawal, MD, MS, FACS, Senior Consultant, Hepatobiliary and Pancreatic Surgery, Department of Surgical Oncology, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, India. shefali_a@apollohospitals.com
Telephone: +91-81-30009660
Received: December 15, 2016
Peer-review started: December 19, 2016
First decision: March 27, 2017
Revised: April 1, 2017
Accepted: May 12, 2017
Article in press: May 13, 2017
Published online: June 10, 2017
Processing time: 168 Days and 8.5 Hours
Abstract

Despite potentially curative surgery pancreatic cancer has a dismal prognosis. Serum cancer antigen 19-9 (CA 19-9) correlates with tumor burden, resectability and survival in patients with pancreatic ductal adenocarcinoma. Identification of novel biomarkers may facilitate early diagnosis of pancreatic cancer and improve survival. Pancreatic juice is a rich source of cancer-specific proteins rendering it a promising tool for identifying biomarkers. Recent proteomic and microRNA expression analyses have identified several biomarkers of potential diagnostic and prognostic value. Tumor markers CA 19-9 and carcinoembryonic antigen (CEA) are widely used in the characterization of premalignant and malignant lesions of the pancreas. Elevated level of CEA in bile is a marker for malignancy and a predictor of hepatic recurrence. The potential value of CA 19-9, CEA and lactate dehydrogenase as prognostic biomarkers in pancreatic juice and bile is unknown. Specimens of pancreatic juice and bile can be readily collected during surgical resection of the tumor. Profiling of pancreatic juice and bile to identify novel prognostic biomarkers may improve selection of patients for adjuvant therapy with a favorable impact on overall survival in patients diagnosed with pancreatic cancer.

Keywords: Prognostic biomarkers; Pancreatic juice; Bile; Pancreatic adenocarcinoma; Surgery

Core tip: Pancreatic juice is a rich source of cancer-specific proteins rendering it a promising tool for identifying novel biomarkers in pancreatic ductal adenocarcinoma. Recent proteomic and microRNA expression analyses have identified several diagnostic and prognostic biomarkers. Elevated carcinoembryonic antigen (CEA) in bile is a marker of malignancy and a predictor of hepatic recurrence. The potential of cancer antigen 19-9, CEA and lactate dehydrogenase as prognostic biomarkers in pancreatic juice and bile is unknown. Specimens of pancreatic juice and bile can be readily collected during pancreatic resection. Profiling of pancreatic juice and bile to identify novel biomarkers may facilitate early diagnosis and improve selection of patients for adjuvant therapy.