A hasnyálmirigy daganatok korai diagnosztikájának új lehetőségei
Benke Márton Milán
Surgical Medicine Division
Dr. Szijártó Attila
Semmelweis Egyetem Sebészeti, Transzplantációs és Gasztroenterológiai Klinika
2025-09-24 15:00:00
Surgical, interventional treatment and transplantation in abdominal organs
Dr. Szijártó Attila
Dr. Szücs Ákos
Dr. Budai András
Dr. Bursics Attila
Dr. Ondrejka Pál
Dr. Miheller Pál
Dr. Csapó Zsolt
The first stage of the thesis is a prognostic meta-analysis that answers the question of whether the preoperative serum CA 19-9 level is suitable for determining the surgical resectability of pancreatic ductal adenocarcinoma. Based on our results, the preoperative serum CA 19-9 level is an acceptable marker for assessing the resectability of PDAC, the overall AUC value is 0.79 (CI: 0.69–0.89). Despite the fact that there is a significant difference between preoperative serum CA19-9 values in resectable and non-resectable cases, it is only an "acceptable" marker, its utility is limited, especially in clinical practice, so CA 19-9 alone cannot be used to decide the resectability of PDAC. We continued and further searched for biomarkers that can be used in the early identification of pancreatic tumors. During the second stage of our research, we proved the presence of EVs in human pancreatic juice samples. Examining EV-associated proteins isolated from pancreatic juice, we identified potential biomarkers, these were MUC1, MUC4, MUC5AC, MUC6 and MUC16, CFTR and MDR1 proteins. They were also detected by flow cytometry in EVs isolated from pancreatic juice in EVs secreted by pancreatic cancer cell lines. Overall, the results of our research show that the detection and characterization of EVs can be performed directly from the pancreatic juice samples and can prove to be a valuable source of potential biomarkers for pancreatic cancer. As the third stage of the thesis, we examined the properties of potentially malignant pancreatic cystic neoplasias in search of a biomarker that can be used as a predictor of the risk of malignancy. We show that chronic pancreatitis derived and PCN fluid samples contain CD63+ EVs but not CD81+ EVs. Interestingly, we did not find a correlation between the concentration of EVs and the clinical diagnosis in any of the investigated parameters, such as the patient category (PC, PCN, M-PCN or non-M-PCN patients). We demonstrated that there are common miRNAs in the content of M-PCN-derived EVs. Comparing M-PCN with S-PCN and pseudocyst-derived EVs (non-M), we found that miR-200b is specific for M-PCN-derived EVs. EV-derived miRNA outperforms some other classical diagnostic methods, such as panreatic cyst fluid CEA, or imaging studies, in terms of both sensitivity and specificity, as well as positive and negative predictive values.
