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Exosomal glypican-1 discriminates pancreatic ductal adenocarcinoma from chronic pancreatitis

  • Author Footnotes
    ⁎ These authors have contributed equally to this work.
    P. Moutinho-Ribeiro
    Footnotes
    ⁎ These authors have contributed equally to this work.
    Affiliations
    Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal

    Medical Faculty of the University of Porto, Porto, Portugal
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  • Author Footnotes
    ⁎ These authors have contributed equally to this work.
    B. Adem
    Footnotes
    ⁎ These authors have contributed equally to this work.
    Affiliations
    Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal

    Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal

    Instituto de Ciências Biomédicas Abel Salazar (ICBAS), University of Porto, Porto, Portugal
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  • I. Batista
    Affiliations
    Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal

    Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal
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  • M. Silva
    Affiliations
    Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal

    Medical Faculty of the University of Porto, Porto, Portugal
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  • S. Silva
    Affiliations
    Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal

    Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal

    iBiMED - Institute of Biomedicine, University of Aveiro
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  • C.F. Ruivo
    Affiliations
    Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal

    Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal

    Instituto de Ciências Biomédicas Abel Salazar (ICBAS), University of Porto, Porto, Portugal
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  • R. Morais
    Affiliations
    Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal

    Medical Faculty of the University of Porto, Porto, Portugal
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  • A. Peixoto
    Affiliations
    Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal

    Medical Faculty of the University of Porto, Porto, Portugal
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  • R. Coelho
    Affiliations
    Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal

    Medical Faculty of the University of Porto, Porto, Portugal
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  • P. Costa-Moreira
    Affiliations
    Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal

    Medical Faculty of the University of Porto, Porto, Portugal
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  • S. Lopes
    Affiliations
    Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal

    Medical Faculty of the University of Porto, Porto, Portugal
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  • F. Vilas-Boas
    Affiliations
    Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal

    Medical Faculty of the University of Porto, Porto, Portugal
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  • C. Durães
    Affiliations
    Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal

    Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal
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  • J. Lopes
    Affiliations
    Serviço de Anatomia Patológica, Centro Hospitalar Universitário de São João, Porto, Portugal
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  • H. Barroca
    Affiliations
    Serviço de Anatomia Patológica, Centro Hospitalar Universitário de São João, Porto, Portugal
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  • F. Carneiro
    Affiliations
    Medical Faculty of the University of Porto, Porto, Portugal

    Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal

    Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal

    Serviço de Anatomia Patológica, Centro Hospitalar Universitário de São João, Porto, Portugal
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  • S.A. Melo
    Affiliations
    Medical Faculty of the University of Porto, Porto, Portugal

    Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto, Porto, Portugal

    Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal
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  • G. Macedo
    Correspondence
    Corresponding author.
    Affiliations
    Serviço de Gastrenterologia, Centro Hospitalar Universitário de São João, Porto, Portugal

    Medical Faculty of the University of Porto, Porto, Portugal
    Search for articles by this author
  • Author Footnotes
    ⁎ These authors have contributed equally to this work.
Published:November 25, 2021DOI:https://doi.org/10.1016/j.dld.2021.10.012

      Abstract

      Background and aims

      Pancreatic ductal adenocarcinoma (PDAC) diagnosis can be difficult in a chronic pancreatitis (CP) background, especially in its mass forming presentation. We aimed to assess the accuracy of glypican-1-positive circulating exosomes (GPC1+crExos) to distinguish PDAC from CP versus the state-of-the-art CA 19–9 biomarker.

      Methods

      This was a unicentric prospective cohort. Endoscopic ultrasound with fine-needle aspiration or biopsy and blood tests (GPC1+crExos and serum CA 19–9) were performed.

      Results

      The cohort comprised 60 PDAC and 29 CP (7 of which mass forming - MF) patients. Median levels of GPC1+crExos were significantly higher in PDAC (99.7%) versus CP (28.4%; p<0.0001) with an AUROC of 0.96 with 98.3% sensitivity and 86.2% specificity for a cut-off of 45.0% (p<0.0001); this outperforms CA 19–9 AUROC of 0.82 with 78.3% sensitivity and 65.5% specificity at a cut-off of 37 U/mL (p<0.0001). The superiority of% GPC1+crExos over CA 19–99 in differentiating PDAC from CP was observed in both early (stage I) and advanced tumors (stages II-IV).

      Conclusion

      Levels of GPC1+crExos coupled to beads enable differential diagnosis between PDAC and CP including its mass-forming presentation.

      Keywords

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