Discriminating patients with early-stage pancreatic cancer or chronic pancreatitis using serum electrospray mass profiling

• We evaluated and distinguished patients with early-stage PDAC using serum ESI-MS profiling.
• We evaluated and distinguished patients with chronic pancreatitis using serum ESI-MS profiling.
• We validated blind patient samples to the appropriate patient groups.
• We observed a cancer phenotype with elements of PDAC in early-stage PDAC/control discrimination.

Blood tests are needed to aid in the early detection of pancreatic ductal adenocarcinoma (PDAC), and monitoring pancreatitis development into malignancy especially in high risk patients. This study exhibits efforts and progress toward developing such blood tests, using electrospray-mass spectrometry (MS) serum profiling to distinguish patients with early-stage PDAC or pancreatitis from each other and from controls. Identification of significant serum mass peak differences between these individuals was performed using t tests and “leave one out” cross validation. Serum mass peak distributions of control individuals were distinguished from those of patients with chronic pancreatitis or early-stage PDAC with P values <10−15, and patients with chronic pancreatitis were distinguished from those of patients with early-stage PDAC with a P value <10−12. Sera from 12 out of 12 patients with PDAC stages I, IIA and IIB were blindly validated from controls. Tandem MS/MS identified a cancer phenotype with elements of PDAC involved in early-stage PDAC/control discrimination. These studies indicate electrospray-MS mass profiling can detect serum changes in patients with pancreatitis or early-stage pancreatic cancer. Such technology has the potential to aid in early detection of pancreatic cancer, biomarker development, and in monitoring development of pancreatitis into PDAC.