British scientists have developed a urine test that can not only accurately detect early-stage cancer, but can also distinguish between pancreatic cancer and the inflammatory condition chronic pancreatitis.
Researchers at arts Cancer Institute, Queen Mary University of London showed through their research involving a total of 488 urine samples (192 from patients known to have pancreatic cancer, 92 from patients with chronic pancreatitis and 87 from healthy volunteers) that a combination of three proteins found at high levels in urine can accurately detect most common form of pancreatic cancer in its early stages and distinguish between this cancer and pancreatitis. A further 117 samples from patients with other benign and malignant liver and gall bladder conditions were used for further validation.
Of the 1500 proteins that researchers found in the urine samples, hree proteins – LYVE1, REG1A and TFF1 – were selected for closer examination, based on biological information and performance in statistical analysis. Patients with pancreatic cancer were found to have increased levels of each of the three proteins when compared to urine samples from healthy patients, while patients suffering from chronic pancreatitis had significantly lower levels than cancer patients.
When combined, the three proteins formed a robust panel that can detect patients with stages I-II pancreatic cancer with over 90 per cent accuracy.
With few specific symptoms even at a later stage of the disease, more than 80 per cent of people with pancreatic cancer are diagnosed when the cancer has already spread. This means they are not eligible for surgery to remove the tumour – currently the only potentially curative treatment.
The five-year survival rate for pancreatic cancer in the UK is the lowest of any common cancer, standing at 3 per cent. This figure has barely improved in 40 years. There is no early diagnostic test available.
Lead researcher, Dr Tatjana Crnogorac-Jurcevic, said: “We’ve always been keen to develop a diagnostic test in urine as it has several advantages over using blood. It’s an inert and far less complex fluid than blood and can be repeatedly and non-invasively tested. It took a while to secure proof of principle funding in 2008 to look at biomarkers in urine, but it’s been worth the wait for these results. This is a biomarker panel with good specificity and sensitivity and we’re hopeful that a simple, inexpensive test can be developed and be in clinical use within the next few years.”
The team is looking into conducting further tests on urine samples from people in high risk groups, to further validate their findings.
Dr Crnogorac-Jurcevic is also keen to access samples of urine collected from volunteers over a period of 5-10 years. By examining samples from donors who went on to develop pancreatic cancer, this ‘longitudinal’ information will allow the researchers to see if the 3-biomarker signature is present during the latency period – the time between the genetic changes that will cause the cancer to develop and the clinical presentation.
“For a cancer with no early stage symptoms, it’s a huge challenge to diagnose pancreatic cancer sooner, but if we can, then we can make a big difference to survival rates,” says co-author and Director of Barts Cancer Institute, Professor Nick Lemoine. “With pancreatic cancer, patients are usually diagnosed when the cancer is already at a terminal stage, but if diagnosed at stage 2, the survival rate is 20 per cent, and at stage 1, the survival rate for patients with very small tumours can increase up to 60 per cent.”
