Evaluation of serum ATX and LPA as potential diagnostic biomarkers in patients with pancreatic cancer

BackgroundPancreatic cancer (PC) is a devastating disease that has a poor prognosis and a total 5-year survival rate of around 5%. The poor prognosis of PC is due in part to a lack of suitable biomarkers that can allow early diagnosis. The lysophospholipase autotaxin (ATX) and its product lysophosphatidic acid (LPA) play an essential role in disease progression in PC patients and are associated with increased morbidity in several types of cancer. In this study, we evaluated both the potential role of serum LPA and ATX as diagnostic markers in PC and their prognostic value for PC either alone or in combination with CA19-9.MethodsATX, LPA and CA19-9 levels were evaluated using ELISA of serum obtained from PC patients (n=114) healthy volunteers (HVs: n=120) and patients with benign pancreatic diseases (BPDs: n=94).ResultsSerum levels of ATX, LPA and CA19-9 in PC patients were substantially higher than that for BPD patients or HVs (p<0.001). The sensitivity of LPA in early phase PC was 91.74% and the specificity of ATX was 80%. The levels of ATX, LPA and CA19-9 were all substantially higher for early stage PC patients compared to levels in serum from BPD patients and HVs. The diagnostic efficacy of CA19-9 for PC was significantly enhanced by the addition of ATX and LPA (p=0.0012).ConclusionMeasurement of LPA and ATX levels together with CA19-9 levels can be used for early detection of PC and diagnosis of PC in general.

Automated summary

Serum levels of ATX, LPA, and CA19-9 were significantly higher in PC patients compared to BPD patients and HVs, with LPA showing a sensitivity of 91.74% and ATX a specificity of 80% for early phase PC. The diagnostic efficacy of CA19-9 for PC was significantly improved by combining it with ATX and LPA.