Chronic pancreatitis is a chronic inflammatory disorder, triggered by various factors. Several factors increase the risk of the development of pancreatic adenocarcinoma, including age, smoking, and chronic alcohol consumption. Predictors for cancer development are currently not available in the stage of chronic pancreatitis; and technical procedures such as endoscopic ultrasound or MRI scanning techniques are often hampered by a low specificity of cancer prediction. Thus, pancreatic cancer is often diagnosed at advanced stages, and chemotherapy does not improve the outcome dramatically. A reliable test in blood, tumor or bile would help to detect the tumors at earlier stage. Most interestingly, a new predictive parameter has recently evolved since MicroRNAs have been associated with cancer development and progression, and recent scientific evidence suggests that MicroRNAs can be regarded as “tumor markers” since several molecules are expressed at high levels in the tumors themselves throughout different patient groups. MicroRNAs expression profiles even seems to classify human gastrointestinal cancer better that MicroRNAs –protein expression profiles. Among the various molecules, miR- 21, miR-34a, miR-198, mir-155 and miR-217 have been shown to be highly specific as biomarkers differentiating between chronic pancreatitis and pancreatic ductal adenocarcinoma. Also, MicroRNAs-196a and -196b have been described as potential biomarkers for the early detection of familial pancreatic cancer. Pilot studies now aim to develop a diagnostic test for pancreatic ductal adenocarcinoma based on differential expression of select MicroRNAs in plasma and bile, not only to predict cancer development but also to understand molecular basis of cancer pr ogression.
Christian Prinz and David Weber
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