New combined microRNA and protein plasmatic biomarker panel for pancreatic cancer

Introduction: Lack of diagnostic makers results in loss of operation opportunity in that most patients are diagnosed at the late stage. Pancreatic cancer (PC) has been regarded as a fatal disease with a 5-year survival rate below 10%. Therefore, the development of diagnostic biomarkers for PC is in urgent need to control the mortality of the disease. Materials and Methods: This is a case-control study including 640 plasma samples from healthy controls (HC), patients with benign pancreatic diseases (BPD), patients with PC; and patients with other gastrointestinal (GI) cancers. Eight biomarker candidates, including miR-20a, miR-21, miR-25, miR-155, miR-196a, miR-210, Macrophage Inhibitory Cytokine-1(MIC-1) and CA19-9, were evaluated to establish two diagnostic indexes in this study. Results: The plasma level of the six miRNAs and MIC-1, CA19-9 were elevated in PC patients compared with those of healthy controls (P< 0.001). Among them, miR-20a, miR-21, miR-25, MIC-1 and CA19-9 could distinguish PC patients from those with other GI cancers or BPD. With multivariable logistic regression, we established two specific indexes for diagnosis of PC(Index1 contains miR-21, MIC-1 and CA19-9; Index2 contains miR-25, MIC-1 and CA19-9). In a randomized setting of 260 HC, 168 PC, 132 other GI cancers and 80 BPD patients, both indexes performed not only better sensitivity for PC but also better specificity to distinguish PC from other GI cancers than CA19-9 and individual biomarkers. Conclusions: These results indicated that combination of biomarkers as a panel could improve diagnostic values compared with using a single marker. Such panels as illustrated in this study could provide novel plasmatic biomarker for PC diagnosis.