Biomarkers of Chronic Pancreatitis: A systematic literature review

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5 Scopus citations

Abstract

Background: Chronic pancreatitis (CP) does not have diagnostic or prognostic biomarkers. CP is the end stage of a progressive inflammatory syndrome that is diagnosed at late stages by morphologic features. To diagnose earlier stages of the disease, a new mechanistic definition was established based on identifying underlying pathogenic processes and biomarker evidence of disease activity and stage. Although multiple risk factors are known, the corresponding biomarkers needed to make a highly accurate diagnosis of earlier disease stages have not been established. The goal of this study is to systematically analyze the literature to identify the most likely candidates for development into biomarkers of CP. Methods: We conducted a systematic review of candidate analytes from easily accessible biological fluids and identified 67 studies that compared CP to nonpancreatic-disease controls. We then ranked candidate biomarkers for sensitivity and specificity by area under the receiver operator curves (AUROCs). Results: Five biomarkers had a large effect size (an AUROC > 0.96), whereas 30 biomarkers had a moderate effect size (an AUROC between 0.96 and 0.83) for distinguishing CP cases from controls or other diseases. However, the studies reviewed had marked variability in design, enrollment criteria, and biospecimen sample handling and collection. Conclusions: Several biomarkers have the potential for evaluation in prospective cohort studies and should be correlated with risk factors, clinical features, imaging studies and outcomes. The Consortium for the Study of Chronic Pancreatitis, Diabetes and Pancreas Cancer provides recommendations for avoiding design biases and heterogeneity in sample collection and handling in future studies.

Original languageEnglish
Pages (from-to)323-333
Number of pages11
JournalPancreatology
Volume21
Issue number2
DOIs
StatePublished - Mar 2021

Bibliographical note

Funding Information:
Grant Support : Supported by the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer and by grants from the National Cancer Institute and the National Institute of Diabetes and Digestive and Kidney Diseases under the following award numbers: U01DK108314 , Cedars-Sinai Medical Center ; U01DK108332 and U01DK108288 , Mayo Clinic ; U01DK108327 , The Ohio State University ; U01DK108320 , University of Florida ; U01DK108306 , University of Pittsburgh ; and U01DK108328 , The University of Texas MD Anderson Cancer Center . The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute, the National Institute of Health, or the National Institute of Diabetes and Digestive and Kidney Diseases.

Funding Information:
Grant Support: Supported by the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer and by grants from the National Cancer Institute and the National Institute of Diabetes and Digestive and Kidney Diseases under the following award numbers: U01DK108314, Cedars-Sinai Medical Center; U01DK108332 and U01DK108288, Mayo Clinic; U01DK108327, The Ohio State University; U01DK108320, University of Florida; U01DK108306, University of Pittsburgh; and U01DK108328, The University of Texas MD Anderson Cancer Center. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute, the National Institute of Health, or the National Institute of Diabetes and Digestive and Kidney Diseases.

Publisher Copyright:
© 2021 IAP and EPC

Keywords

  • Biomarker
  • Chronic pancreatitis
  • Early detection
  • Pancreatitis
  • PRoBE strategy

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Gastroenterology

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