Familial pancreatic cancer. Cancers (Basel). 2010;2:1861-1883. [PMID: 24281205 PMCID: PMC3840451 DOI: 10.3390/cancers2041861]

Using probe electrospray ionization mass spectrometry and machine learning for detecting pancreatic cancer with high performance

A rapid blood-based diagnostic modality to detect pancreatic ductal adenocarcinoma (PDAC) with high accuracy is an unmet medical need. The study aimed to validate a unique diagnosis system using Probe Electrospray Ionization Mass Spectrometry (PESI-MS) and Machine Learning to the diagnosis of PDAC. Peripheral blood samples were collected from a total of 322 consecutive PDAC patients and 265 controls with a family history of PDAC. Five µl of serum samples were analyzed using PESI-MS system. The mass spectra from each specimen were then fed into machine learning algorithms to discriminate between control and cancer cases. A total of 587 serum samples were analyzed. The sensitivity of the machine learning algorithm using PESI-MS profiles to identify PDAC is 90.8% with specificity of 91.7% (95% CI 83.9%-97.4% and 82.8%-97.7% respectively). Combined PESI-MS profiles with age and CA19-9 as predictors, the accuracy for stage 1 or 2 of PDAC is 92.9% and for stage 3 or 4 is 93% (95% CI 86.3-98.2; 87.9-97.4 respectively). The accuracy and simplicity of the PESI-MS profiles combined with machine learning provide an opportunity to detect PDAC at an early stage and must be applicable to the examination of at-risk populations.

Familial atypical multiple mole melanoma (FAMMM) syndrome: history, genetics, and heterogeneity

Approximately 5-10 % of cutaneous melanoma occurs in kindreds with a hereditary predisposition. Mutations in the CDKN2A gene are found to occur in approximately 20-40 % of these kindreds. The first historical mention of what is now called the familial atypical multiple mole melanoma syndrome appears to be from 1820, with more reports throughout the 1950s, 1960s, and later years. In 1991, Lynch and Fusaro described an association between familial multiple mole melanoma and pancreatic cancer and work continues to elucidate the syndrome's genotypic and phenotypic heterogeneity. Individuals at risk for familial melanoma need periodic screenings. Unfortunately, adequate screening for pancreatic cancer does not currently exist, but pancreatic cancer's prominence in the hereditary setting will hopefully act as a stimulus for development of novel screening measures.

Histone deacetylases, microRNA and leptin crosstalk in pancreatic cancer

Because pancreatic cancer (PC) historically has had poor prognosis and five year survival rates, it has been intensely investigated. Analysis of PC incidence and biology has shown a link between different risk factors such as smoking, alcoholism, and obesity and disease progression. Important factors affecting PC include the epigenomic changes driven by DNA methylation and histone acetylation, and actions of microRNA inducing oncogenic or tumor suppressor effects. Studies have identified markers whose dysregulation seem to play important roles in PC progression. PC markers involve classical histone deacetylases (HDAC), PC stem cell (PCSC), and leptin. In this review, we discuss the role of several PC biomarkers, and the potential crosstalk between HDAC, microRNA, and leptin in PC progression. Dysregulated expression of these molecules can increase proliferation, survival, PCSC, resistance to chemotherapy and tumor angiogenesis. The potential relationships between these molecules are further analyzed using data from The Cancer Genome Atlas and crosstalk pathways generated by the Pathway Studio Platform (Ariadne Genomics, Inc.). Oncogenic miRNA21 and tumor suppressor miRNA200 have been previously linked to leptin signaling. Preliminary analysis of PC biopsies and signaling crosstalk suggests that the main adipokine leptin could affect the expression of microRNA and HDAC in PC. Data analysis suggests that HDAC-microRNA-leptin signaling crosstalk may be a new target for PC therapy.