Bloedtest met vier tumormarkers ontdekt alvleesklierkanker al in vroeg stadium met een nauwkeurigheid van 87 tot 91 procent. Dit geeft hoop op een vroegere diagnose en een betere overlevingskans van alvleesklierkanker

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12 februari 2026. Bron: 2026 Jan 28:OF1-OF14. Online ahead of print.

Wanneer de tumormarkers ANPEP en PIGR worden toegevoegd aan de tumormarkers CA 19-9 en THBS2 bij een analyse van de gegevens verzameld via een bloedtest bij mensen met aangetoonde alvleesklierkanker en vergeleken met mensen die geen aantoonbare ziekte hadden dan blijkt de bloedtest met een nauwkeurigheid van 91,9 procent alvleesklierkanker in alle stadia te onderscheiden van gezonde mensen met een vals-positief percentage van 5% bij de groep mensen zonder aantoonbare ziekte. Voor alvleesklierkanker in een vroeg stadium I/II identificeerde de bloedtest met de combinatie van de vier markers 87,5% van de gevallen.

Dat blijkt uit een studie via een bloedtest van wetenschappers aan de Universiteit van Pennsylvania Perelman school en de Mayo clinic in Rochester Minnesota.

In het onderzoek gebruikten de wetenschappers een gefaseerde aanpak om biomarkers te testen in bloed afgenomen van patiënten met alvleesklierkanker en vergelijkbare mensen / vrijwilligers zonder deze ziekte.
In de eerste fase werden twee bloedbiomarkers CA 19-9 en THBS2, die min of meer standaard worden gebruikt om de respons op de behandeling bij patiënten met alvleesklierkanker te monitoren. Geen van beide tumormarkers bleek goed te werken als screeningsinstrument. CA 19-9 kan namelijk ook verhoogd zijn bij mensen met goedaardige aandoeningen zoals pancreatitis en en een galwegobstructie, terwijl andere patiënten het door genetische factoren helemaal niet aanmaken.
De onderzoekers onderzochten in de tweede fase opgeslagen bloedmonsters en identificeerden de onderzoekers twee extra eiwitten die in hogere concentraties aanwezig waren bij mensen met alvleesklierkanker in een vroeg stadium vergeleken met gezonde vrijwilligers. Deze eiwitten waren aminopeptidase N (ANPEP) en polymere immunoglobulinereceptor (PIGR).

Met als resultaat dat 91,9 procent werd ontdekt bij alvleesklierkanker in alle stadia van I tot IV. En bij 87,5 procent bij stadium I/II dat meestal nog operabel is.

De wetenschappers zijn heel enthousiast over deze resultaten want wanneer alvleesklierkanker in een vroeg stadium kan worden ontdekt is het meestal nog operabel en stijgen de overlevingskansen.

Het volledige studierapport is gratis in te zien, klik daarvoor op de titel van het abstract:

Abstract

Purpose: Pancreatic ductal adenocarcinoma (PDAC) is typically detected too late for useful therapeutic interventions; hence, we sought blood biomarkers to detect early-stage disease.

Experimental design: Using mass spectrometry and ELISA on plasma pools from the University of Pennsylvania (Penn) and the Mayo Clinic (Mayo), we identified aminopeptidase N (ANPEP) and polymeric immunoglobulin receptor (PIGR) as increased in early-stage (stage I/II) PDAC plasma compared with controls. We tested ANPEP and PIGR, along with prior data for thrombospondin 2 (THBS2) and carbohydrate antigen 19-9 (CA19-9), in retrospective phase II studies using separate cohorts of PDAC plasmas at different stages versus healthy or nonmalignant disease controls (DC) from Penn (n = 135) and Mayo (n = 537).

Results: Comparing healthy controls with stage I/II PDAC, we obtained area under the receiver-operating characteristic curves (AUC) of 0.78 [95% confidence interval (CI), 0.68-0.86]/0.80 (95% CI, 0.74-0.85; ANPEP) and 0.81 (95% CI, 0.70-0.88)/0.86 (95% CI, 0.82-0.90; PIGR) for the Penn/Mayo phase II studies, respectively. In multivariable models, CA19-9/THBS2/ANPEP, CA19-9/THBS2/PIGR, and CA19-9/THBS2/ANPEP/PIGR elicited AUC of 0.94 to 0.96 for Penn and 0.97 for Mayo. Notably, the four-marker panel elicited AUC of 0.87 for the Mayo stage I/II versus DC and 0.91 for stages I to IV versus DC. At a specificity of 95%, a plasma biomarker panel composed of CA19-9 (≥35 U/mL), THBS2 (≥42 ng/mL), ANPEP (≥2,995 ng/mL), and PIGR (≥1,800 ng/mL) yielded a sensitivity of 91.9% for PDAC stages I to IV and 87.5% for PDAC stage I/II.

Conclusions: Adding ANPEP and PIGR to a plasma biomarker panel of CA19-9 and THBS2 enhances the detection of early-stage PDAC when comparing cancer versus healthy or nonmalignant DC. Given the concordance of our data in two retrospective phase II studies, assessments in prediagnostic cases are warranted.

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Conflict of interest statement

Conflict of interest statement:

Mayo Clinic and Exact Sciences have an intellectual property development agreement. Dr. Majumder is listed as inventor under this agreement and could share potential future royalties as employee of Mayo Clinic. None of the other authors declare a conflict with this study.

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