TY - JOUR
T1 - Biomarkers of Chronic Pancreatitis
T2 - A systematic literature review
AU - Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer
AU - Cruz-Monserrate, Zobeida
AU - Gumpper, Kristyn
AU - Pita, Valentina
AU - Hart, Phil A.
AU - Forsmark, Christopher
AU - Whitcomb, David C.
AU - Yadav, Dhiraj
AU - Waldron, Richard T.
AU - Pandol, Stephen
AU - Steen, Hanno
AU - Anani, Vincent
AU - Kanwar, Natasha
AU - Vege, Santhi Swaroop
AU - Appana, Savi
AU - Li, Liang
AU - Serrano, Jose
AU - Rinaudo, Jo Ann S.
AU - Topazian, Mark
AU - Conwell, Darwin L.
N1 - Publisher Copyright:
© 2021 IAP and EPC
PY - 2021/3
Y1 - 2021/3
N2 - 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.
AB - 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.
KW - Biomarker
KW - Chronic pancreatitis
KW - Early detection
KW - PRoBE strategy
KW - Pancreatitis
UR - http://www.scopus.com/inward/record.url?scp=85100421391&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85100421391&partnerID=8YFLogxK
U2 - 10.1016/j.pan.2021.01.006
DO - 10.1016/j.pan.2021.01.006
M3 - Article
C2 - 33558189
AN - SCOPUS:85100421391
SN - 1424-3903
VL - 21
SP - 323
EP - 333
JO - Pancreatology
JF - Pancreatology
IS - 2
ER -