Cysts to reveal pancreatic cancer risk

Washington: American researchers have come up with a method that could be used to predict whether pancreatic cysts are benign or precursors to invasive cancer.

The study, conducted by researchers from the University of Michigan, Indiana University and Van Andel Research Institute (VARI), has appeared in the Annals of Surgery.

First author Brian Haab, VARI Senior Scientific Investigator, said: "Because of the difficulty in detecting pancreatic cancer in its early stages, most cancers are advanced at the time of diagnosis and recur after removal of the tumor.

"The best hope for a long-term cure may be the detection and removal of these pre-cancerous cysts."

Peter J. Allen, a physician and researcher specializing in pancreatic, liver, and stomach cancer at Memorial Sloan-Kettering Cancer Center, said: "Dr. Haab and his colleagues have sought to address a very challenging clinical management problem regarding cystic lesions of the pancreas.

"As the use of cross-sectional imaging increases, clinicians are seeing increased numbers of patients with these lesions and it will become imperative to sort out benign from pre-malignant."

The most common and deadly form of pancreatic cancer, pancreatic ductal adenocarcinomas, develops from three types of cysts.

Although the most prevalent type is too small to be detected, the other two can be found using CT or ultrasound imaging and account for 10 - 15 per cent of pancreatic cancers.

However, current methods can only distinguish pre-cancerous cysts from those that are benign with up to 79 per cent accuracy.

Using fluid from a variety of cyst types, researchers looked for patterns in the variations of carbohydrate structures called glycans to determine if there were any biomarkers that could more accurately distinguish between pre-cancerous and benign cysts.

They found several candidates, some of which could be used in combination to determine cyst type.

Dr. Haab said: "Further study will be needed to validate the clinical value of using glycan variations to differentiate cyst types, but it seems like they are more accurate than current methods."

Dr. Allen said: "(Dr. Haab`s) identification of variants of MUC-1, MUC-5AC, and MUC-16 (genes) within the cyst fluid of pre-malignant lesions is exciting as our current ability to non-operatively define these lesions is limited.

"Hopefully with larger numbers of patients these results can be validated and be put into clinical use."