Studies Of Relationship Between Serum Trypsinogen-2 And Pancreatic Cancer

BackgroudPancreatic cancer, although infrequent, has a very poor prognosis. Successful surgery at earlytumor stages is the only curative therapy today. However, 80-90% of patients has presented withmetastatic or locally advanced disease at the time of diagnosis. Consequently, early detection iscrucial for curative treatment. Clinical routine still lacks efficient, non-invasive screening assays.When pancreatic cancer happened, pancreatic tissue was damaged, some cytokines orcarcinogens might be secreted into blood. Theoretically they could be specificity and sensitivityindexes in screening. A wide range of serum proteins have been on the focus of intensivesearching for biomarkers specific for pancreatic cancer. Trypsinogen-2 is a serine proteinase,mainly secreted to pancreatic secretion as the form of proenzyme. Currently most studiesfocused on the relationship between it and pancreatitis. Few research found that trypsinogen-2had high level in pancreatic cancer and it might be relevant to pancreatic cancer. Papers aboutserum trypsinogen-2 in pancreatic cancer were rare.ObjectiveTo investigate the relationship between serum trypsinogen-2 and pancreatic cancer, todetermine the cut-off value of diagnosis of pancreatic cancer.MethodsSerum samples were collected preoperatively from 23 pancreatic cancer patients, 30pancreatitis patients invasion within 12 hours and without treatment by somatostatin from theInternal, Surgical Department and 35 healthy individuals who underwent health examinationduring 12/2009~6/2010 at PLA Beijing Army General Hospital(12/2009~6/2010).The serum concentrations were stored aliquoted at -70℃until using, unified determined byELISA.ResultsThe median level of serum trypsinogen-2 was 0.8μg/L in controls, Interquartile Range was0.6~1.2μg/L, 13.8μg/L and 2.3~60.μg/L in pancreatic cancer. 82.7μg/L and 21. 45~201.5μg/L inpatients with pancreatitis, there were statistically differences among them(P<0.01). Thesensitivity and specificity for distinguishing pancreatic cancer and control group was 91. 4%,95.7%, respectively, the area under the ROC curve was 0.989. When the specificity was set at80%, the sensitivity for differentiation between pancreatic cancer and pancreatitis was 56.5%.The area under the ROC curve was 0.725. There was positive correlation between content ofserum trypsinogen-2 and Balthazar CT Grade (P=0. 003, P<0. 01), the coefficient of Spearman correlation was 0.524.ConclusiConclusion(1) There were statistically differences among the content of serum trysinogen-2 in pancreaticcancer, pancreatitis and the controls. Serum trypsinogen-2 was correlated with pancreatic cancer.(2) There was positive correlation between the content of serum trysinogen-2 and BalthazarCT Grade in pancreatitis patients. There was positive correlation between the content of serumtrysinogen-2 and the level of pancreatic injury.(3) Our study suggested that it was highly suspected pancreatic cancer when the level of serumtrypsiongen-2 was from 1.85μg/L to 15.55μg/L.