Application Of Serum Peptidomics,Serum Galectin-3 And Other Tumor Markers In The Diagnosis And Differential Diagnosis Of Pancreatic Ductal Adenocarcinoma And Chronic Pancreatitis

[Objective]To investigate the application of serum peptidomics and tumor markers in the diagnosis and differential diagnosis of pancreatic ductal adenocarcinoma(PDAC)and chronic pancreatitis(CP).[Methods]1.Levels of CA19-9,CA125,CEA,Cyfra21-1,CA15-3 and galectin-3 in the serum of 125 patients with PDAC and 115 patients with CP were detected by abbott ARCHITECT i2000 chemiluminescence immunoassay analyzer.2.In this study,serum peptides were extracted by weak cation magnetic beads method,and serum peptides of 176 patients with PDAC,148 patients with CP,and 158 healthy controls were detected by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry.Classification models were established based on the differential peptides,and the sensitivity and specificity of the models were verified by the validation group.3.The differential peptides were identified by nano liquid chromatography-electrospray ionization tandem mass spectrometry.[Results]1.According to ROC analysis,the maximum AUC was CA19-9(AUC=0.856),followed by CA125,CEA and Cyfra21-1.The sensitivity and specificity of CA19-9 were 75.2%and 92.2%,respectively.But,CA15-3 and galectin-3 were difficult to differentiate between PDAC and CP.2.In this study,three classification models were established based on three different groups of serum differential peptides.The first one was a differential diagnosis model of PDAC and CP.The validation group showed a sensitivity of 94.44%and a specificity of 97.78%.The second one is an early screening model for PDAC.The validation group showed a sensitivity of 100%and a specificity of 87.23%.The third one is an auxiliary diagnostic model for CP.The validation group showed a sensitivity of 88.89%and a specificity of 100%.3.This study identified the amino acid sequence of 23 differentially expressed peptides and the types of proteins,including platelet basic protein,fibrinogen alpha,complement C3,complement C4-A,kininogen-1,and secreted curly-associated protein 4.[Conclusion]1.CA19-9 is of great value in the differential diagnosis of pancreatic lesion,while galectin-3 is of little value.2.The serum peptide models can be applied to the diagnosis and differential diagnosis of PDAC and CP.3.The amino acid sequences of the 23 differential peptides and the types of proteins were identified,but their diagnostic values need further verification.