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Thrombospondin-2 is a Highly Specific Diagnostic Marker and is Associated with Prognosis in Pancreatic Cancer

  • Pancreatic Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Thrombospondin-2 (TSP-2) has been reported as an early diagnostic marker for pancreatic ductal adenocarcinoma (PDAC) in Caucasian populations. This study was designed to validateTSP-2 as a diagnostic marker in a large Taiwan cohort and to investigate the association of TSP-2 with the clinical outcomes of PDAC patients.

Methods

The serum TSP-2 levels in 263 PDAC patients and 230 high-risk individuals (HRIs) were measured via an enzyme-linked immunosorbent assay. The sensitivity, specificity, and accuracy of TSP-2 as a diagnostic marker to discriminating PDAC patients from HRIs and correlations between TSP-2 levels and prognosis of PDAC patients were analyzed.

Results

Serum TSP-2 levels were significantly higher in patients with PDAC (44.90 ± 40.70 ng/ml) than in the HRIs (17.52 ± 6.23 ng/ml). At a level of ≥ 29.8 ng/ml, TSP-2 exhibited 100% specificity, 55.9% sensitivity, 100% positive predictive value (PPV), and 66.5% negative predictive value (NPV) for discriminating PDAC patients from HRIs. The Cox regression analysis showed that higher serum TSP-2 levels were significantly associated with poor outcomes in PDAC patients (hazard ratio = 1.54, 95% confidence interval = 1.143–2.086, P = 0.005). Combining the carbohydrate antigen 19-9 (CA19-9) (cutoff value of 62.0 U/ml) and TSP-2 (cutoff value of 29.8 ng/ml) levels yielded 98.7% specificity, 90.5% sensitivity, 98.8% PPV, and 90.1% NPV for discriminating patients with PDAC from HRIs.

Conclusions

TSP-2 is a highly specific diagnostic marker and an independent prognostic marker in patients with PDAC. A combined biomarker panel, including TSP-2 and CA19-9, may facilitate future PDAC screening.

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Acknowledgment

Taiwan Pancreas Foundation; MOST106-2321-B-002-033 and 107-2321-B-002-013.

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Authors and Affiliations

  1. Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan

    Hsuan-Yu Peng PhD, Ming-Chu Chang MD, PhD & Yu-Ting Chang MD, MS, PhD

  2. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan

    Ming-Chu Chang MD, PhD & Yu-Ting Chang MD, MS, PhD

  3. Genomics Research Center, Academia Sinica, Taipei, Taiwan

    Chun-Mei Hu PhD, Hwai-I Yang PhD & Wen-Hwa Lee PhD

  4. Taiwan Graduate Institute of Clinical Medicine, China Medical University, Taichung, Taiwan

    Wen-Hwa Lee PhD

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  1. Hsuan-Yu Peng PhD
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Contributions

Y-TC had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: H-YP, M-CC, C-MH, W-HL, and Y-TC. Acquisition, analysis, or interpretation of data: H-YP, M-CC, C-MH, H-IY, and Y-TC. Drafting of the manuscript: H-YP and Y-TC. Critical revision of the manuscript for important intellectual content: W-HL and Y-TC. Statistical analysis: H-YP, M-CC, and H-IY. Study supervision: W-HL and Y-TC.

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Correspondence to Yu-Ting Chang MD, MS, PhD.

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Peng, HY., Chang, MC., Hu, CM. et al. Thrombospondin-2 is a Highly Specific Diagnostic Marker and is Associated with Prognosis in Pancreatic Cancer. Ann Surg Oncol 26, 807–814 (2019). https://doi.org/10.1245/s10434-018-07109-6

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