Study Finds Biologic Markers Associated With High-Risk Pancreatic Lesions


Key Points

  • Benign and malignant intraductal papillary mucinous neoplasms are difficult to distinguish using imaging and blood tests alone; the only present way to confirm their severity is through surgical removal.
  • Researchers at Moffitt discovered six microRNAs can distinguish between low-risk and high-risk cysts.
  • The investigators hope to develop a microRNA blood test to be used in conjunction with imaging and other diagnostic tools to predict pancreatic cancer severity and aid in earlier detection.

Pancreatic cancer affects approximately 46,000 people each year in the United States, and ranks fourth among the leading causes of cancer-related deaths. Only about 6% of individuals with pancreatic cancer will live 5 years after their diagnosis. One reason for this high mortality rate is the lack of effective tools to detect pancreatic cancer early enough to allow its surgical removal. Moffitt Cancer Center researchers are devising an approach to detect pancreatic cancer earlier, as reported by Permuth-Wey et al in PLoS One.

Intraductal Papillary Mucinous Neoplasms

Similar to the development of colon cancer from precancerous polyps, pancreatic cancer can develop from precursor lesions called intraductal papillary mucinous neoplasms, a type of pancreatic cyst. These cysts can be detected by computed tomography (CT) scans and magnetic resonance imaging (MRI).

Intraductal papillary mucinous neoplasms can be benign or malignant, but it is extremely challenging to accurately differentiate between the two by imaging or blood tests. The only way to determine the severity of an intraductal papillary mucinous neoplasm is by surgically removing it; however, this is associated with serious risks, including long-term diabetes and death. Alternatively, if a physician decides to watch the progression of the cysts over time, they may miss an opportunity to cure a patient who may have a potentially life-threatening disease.

MicroRNAs and Earlier Detection

Moffitt Cancer Center researchers studied biomarkers called microRNAs to see which may be associated with high-risk intraductal papillary mucinous neoplasms that warrant more immediate surgical removal.

"MicroRNAs are small molecules that work as ‘master regulators,’ controlling numerous cancer-related processes in the body. MicroRNAs can be detected in tumor tissues and bodily fluids such as blood, and a growing body of evidence suggests they are promising biomarkers of early pancreatic cancer," said primary author Jennifer Permuth-Wey, PhD, Applied Research Scientist and Molecular Epidemiologist in the Cancer Epidemiology Program at Moffitt.

The researchers analyzed surgically removed intraductal papillary mucinous neoplasm tissue from patients who previously had been diagnosed and treated at Moffitt. They discovered that six microRNAs could distinguish between high-risk and low-risk cysts. “We also provided evidence that the six microRNAs may contribute to pancreatic cancer progression,” said senior author Mokenge P. Malafa, MD, FACS, Department Chair and Program Leader for Moffitt's Gastrointestinal Oncology Program.

“The hope is that this line of research may eventually lead to a microRNA-based blood test that could be used in conjunction with imaging features and other factors to aid the medical team and patient in accurately predicting disease severity at the time of [intraductal papillary mucinous neoplasm] diagnosis or follow-up,” said Dr. Permuth-Wey.

“Importantly, this research may also help foster the development of new prevention and early detection strategies for pancreatic cancer,” said Dr. Malafa.

Dr. Permuth-Wey is the corresponding author for the PLoS One article.

This study was supported by the American Cancer Society, the National Cancer Institute/ United States Public Health Service, and from Programmatic Funds from the Moffitt Gastrointestinal Oncology Program. 

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.