Introduction: Nearly 80 % of patients with pancreatic cancer (PAC) have diabetes mellitus or prediabetes (DM). New-onset DM can be the first symptom of PAC in majority of them. We compared CA 19-9, microRNAs and glucose-dependent insulinotropic polypeptide (GIP) as the PAC biomarkers in DM.

Patients and methods: Forty nine patients with and 31 without PAC were enrolled. All had DM confirmed by ADA criteria and PAC was histologically proven. Twenty five healthy persons were evaluated, too. CA 19-9, miR-192, -196, -200 and GIP were measured in serum samples. Mann-Whitney U test and Kruskal-Wallis ANOVA were used for statistical evaluation. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were determined in the individual markers and in their combinations.

Results: In DM patients with PAC the serum concentrations of CA 19-9 and miRNAs were elevated (p<0.0003) and GIP decreased (p<0.001) in comparison with both DM patients without PAC and non-DM controls. Sensitivity, specificity, PPV and NPV were calculated (Table). While CA 19-9 was not increased in 16 % of patients with PAC, its combination with GIP and miR-200 confirmed PAC diagnosis in all of them.

Conclusion: Addition of miR-200 and GIP to CA 19-9 caused an increase of NPV to 100 % meaning that three combined biomarkers could exclude the diagnosis of PAC. Combination of these biomarkers could be used for PAC screening in DM patients in risk.


P. Skrha: None. A. Horinek: None. J. Skrha: None.


Charles University

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