Utilising pancreatic exocrine insufficiency in the detection of resectable pancreatic ductal adenocarcinoma
Utilising pancreatic exocrine insufficiency in the detection of resectable pancreatic ductal adenocarcinoma
Pancreatic ductal adenocarcinoma (PDAC) is usually diagnosed late, leading to a high mortality rate. Early detection facilitates better treatment options. The aim of this UK-based case–control study was to determine whether two validated tests for pancreatic exocrine insufficiency (PEI), namely, the 13C-mixed triglyceride breath test (13C-MTGBT) and a faecal elastase (FE-1) test, can discriminate between patients with resectable PDAC versus healthy volunteers (HVs) along with a comparison group with chronic pancreatitis (CP). Discrimination between disease states and HVs was tested with receiver operator characteristic (ROC) curves. In total, 59 participants (23 PDAC (16 men), 24 HVs (13 men) and 12 CP (10 men)) were recruited, with a similar age in each population, and a combined median (IQR) age of 66 (57–71). The areas under the ROC curve for discriminating between PDAC and HVs were 0.83 (95% CI: 0.70–0.96) for the 13C-MTGBT, and 0.85 (95% CI: 0.75–0.95) for the FE-1 test. These were similar to CP vs. HV. In conclusion, PEI occurs in resectable PDAC to a similar extent as in CP; further large-scale, prospective studies using these tests in the primary care setting on high-risk groups are warranted.
C, PDAC, PEI, adenocarcinoma, elastase, exocrine, insufficiency, pancreatic, triglyceride
McDonnell, Declan
b7499481-73e7-4130-897e-cd4200c8a43b
Afolabi, Paul
757e7f01-664c-493e-bc51-c6a2c933dc22
Wilding, Sam
a026cae1-cc72-49b5-a52b-ec1d931d72e1
Griffiths, Gareth
7fd300c0-d279-4ff6-842d-aa1f2b9b864d
Swann, Jonathan
7c11a66b-f4b8-4dbf-aa17-ad8b0561b85c
Byrne, Chris
1370b997-cead-4229-83a7-53301ed2a43c
Hamady, Zaed Z.R.
545a1c81-276e-4341-a420-aa10aa5d8ca8
8 December 2023
McDonnell, Declan
b7499481-73e7-4130-897e-cd4200c8a43b
Afolabi, Paul
757e7f01-664c-493e-bc51-c6a2c933dc22
Wilding, Sam
a026cae1-cc72-49b5-a52b-ec1d931d72e1
Griffiths, Gareth
7fd300c0-d279-4ff6-842d-aa1f2b9b864d
Swann, Jonathan
7c11a66b-f4b8-4dbf-aa17-ad8b0561b85c
Byrne, Chris
1370b997-cead-4229-83a7-53301ed2a43c
Hamady, Zaed Z.R.
545a1c81-276e-4341-a420-aa10aa5d8ca8
McDonnell, Declan, Afolabi, Paul, Wilding, Sam, Griffiths, Gareth, Swann, Jonathan, Byrne, Chris and Hamady, Zaed Z.R.
(2023)
Utilising pancreatic exocrine insufficiency in the detection of resectable pancreatic ductal adenocarcinoma.
Cancers, 15 (24), [5756].
(doi:10.3390/cancers15245756).
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is usually diagnosed late, leading to a high mortality rate. Early detection facilitates better treatment options. The aim of this UK-based case–control study was to determine whether two validated tests for pancreatic exocrine insufficiency (PEI), namely, the 13C-mixed triglyceride breath test (13C-MTGBT) and a faecal elastase (FE-1) test, can discriminate between patients with resectable PDAC versus healthy volunteers (HVs) along with a comparison group with chronic pancreatitis (CP). Discrimination between disease states and HVs was tested with receiver operator characteristic (ROC) curves. In total, 59 participants (23 PDAC (16 men), 24 HVs (13 men) and 12 CP (10 men)) were recruited, with a similar age in each population, and a combined median (IQR) age of 66 (57–71). The areas under the ROC curve for discriminating between PDAC and HVs were 0.83 (95% CI: 0.70–0.96) for the 13C-MTGBT, and 0.85 (95% CI: 0.75–0.95) for the FE-1 test. These were similar to CP vs. HV. In conclusion, PEI occurs in resectable PDAC to a similar extent as in CP; further large-scale, prospective studies using these tests in the primary care setting on high-risk groups are warranted.
Text
2023 Utilising pancreatic exocrine insufficiency in the detention of resectable pancreatic ductal adenocarcinoma
- Version of Record
More information
Accepted/In Press date: 6 December 2023
Published date: 8 December 2023
Additional Information:
Funding Information:
This work was supported by CRUK grant number C45617/A29908 and supported by Core funding at the Cancer Research UK Southampton Clinical Trials Unit.
Funding Information:
This was a single-site, unblinded, case–control pilot study in the UK between patients with resectable PDAC, CP, and HV. The protocol for this study has been published as part of the DEPEND project, funded by Cancer Research UK []. Ethical approval was granted by the Health Research Authority (HRA) and Health and Care Research Wales (HCRW) to be conducted in (and sponsored by) the University Hospital Southampton NHS Foundation Trust (UHSFT) (IRAS project ID: 286297, REC reference 20/NS/0105, on 21 October 2020) with study design and statistical support from the Cancer Research UK Southampton Clinical Trials Unit.
Funding Information:
The authors would like to acknowledge the hepatopancreaticobiliary (HPB) surgeons and extended members of the HPB team at UHSFT for their assistance in recruiting participants for this trial. The authors would also like to acknowledge the support of Victoria Goss at the Cancer Research UK Southampton Clinical Trials Unit (SCTU) and Jocelyn Walters MBE at SCTU/Wessex NIHR CRN, who supported the delivery of the study.
Keywords:
C, PDAC, PEI, adenocarcinoma, elastase, exocrine, insufficiency, pancreatic, triglyceride
Identifiers
Local EPrints ID: 485555
URI: http://eprints.soton.ac.uk/id/eprint/485555
ISSN: 2072-6694
PURE UUID: 72e11970-31b4-42e1-9021-91de22248777
Catalogue record
Date deposited: 11 Dec 2023 17:32
Last modified: 18 Mar 2024 04:05
Export record
Altmetrics
Contributors
Author:
Declan McDonnell
Author:
Paul Afolabi
Author:
Zaed Z.R. Hamady
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics