Bile marker flags pancreatic cancer for earlier treatment

While some investigators are seeking better ways to treat pancreatic cancer, others have been tracking biomarkers that can offer a more accurate way to identify the lethal disease earlier on, so patients can be treated while there's a greater chance of fighting the disease.

At the Cleveland Clinic, that effort led to the discovery of a biomarker in bile known as vascular endothelial growth factor (VEGF) that can be used to detect pancreatic cancer in 93% of cases.

Investigators at the Cleveland Clinic found that median bile VEGF levels were raised significantly in patients with pancreatic cancer, based on their study involving 53 patients undergoing endoscopic retrograde cholangiopancreatography, or ERCP. Fifteen of those patients had pancreatic cancer, 18 had primary sclerosing cholangitis, 9 had cholanciocarcinoma (cancer of the bile duct), and 11 had benign conditions of the pancreas and bile duct.

"A VEGF cut of value of 0.5 ng/mL distinguished pancreatic cancer from cholangiocarcinoma and this measure is both 93 percent sensitive and 89 percent specific," reported Dr. Udayakumar Navaneethan of the Cleveland Clinic Foundation. The team confirmed the diagnostic accuracy of biliary VEGF in a second cohort and then further confirmed it in a resected pancreatic cancer case with elevated VEGF in bile.

"In patients with indeterminate biliary strictures, we feel that measurements of markers in bile can help identify pancreatic malignancy and plan for earlier treatment," says Navaneethan. "Also in patients where tissue diagnosis cannot be obtained in spite of multiple biopsies, measurement of markers in bile fluid to improve our diagnostic ability would be of immense interest."

- here's the release

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