Test May Help Spot Pancreatic Cancer



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Test _May_ Help Spot Pancreatic Cancer

New Technique Uses Light to Check Cells Without Major Surgery
By Miranda Hitti

Reviewed by Louise Chang, MD

Aug. 1, 2007 -- A new, no-surgery test may help detect pancreatic cancer
in its earlier, more treatable stages, scientists announced today.

The test isn't ready for patients yet. But if successful in other studies,
it may help people survive pancreatic cancer, which is America's fourth
leading cause of cancer deaths.

The American Cancer Society predicts that this year in the U.S., about
37,170 people will be diagnosed with pancreatic cancer and about 33,370
will die of pancreatic cancer.

"One of the reasons for this grim prognosis for patients is that we still
don't know how to detect it early enough," Northwestern University
biomedical engineering professor Vadim Backman, PhD, said in a news
conference today.

Early detection can make a big difference in survival, and Backman's team
wants to improve patients' chances with their new test, which is described
in today's edition of Clinical Cancer Research.
Pancreatic Cancer Theory

The scientists' theory boils down to this simple idea: When pancreatic
cancer starts, there goes the neighborhood.

That is, pancreatic cancer is associated with subtle changes in
neighboring cells in the duodenum, which is part of the small intestine.

Here's why that's important. Taking biopsies from the pancreas carries a
high risk of complications. But the duodenum can be reached with a simple,
nonsurgical procedure called an upper endoscopy.

In an upper endoscopy, doctors insert a thin tube into the sedated
patient's mouth and guide the tube down the esophagus, through the
stomach, and to the small intestine.

"It was, in a sense, a fishing expedition, because the pancreas and the
duodenum are two different organs," Backman says. "There was a big
question of if we would able to sense any differences in the otherwise
normal duodenal tissue that would correlate with the presence of
pancreatic cancer."
New Pancreatic Cancer Test

Backman's team gave upper endoscopies to 19 people who had already been
diagnosed with pancreatic cancer and to 32 people without pancreatic
cancer.

The scientists took small tissue samples (biopsies) from each person's
duodenum and examined those biopsies in their lab.

This was no ordinary lab test. The researchers used a bright light and a
special microscope to check for optical markers -- essentially, a
fingerprint -- linked to pancreatic cancer.

All of the participants had duodenal cells that looked healthy under a
normal microscope, even if they had pancreatic cancer.

But when the scientists put those cells in the spotlight through their
special microscope, they noticed extremely small architectural differences
in the duodenal cells of the pancreatic cancer patients.

Those changes were so tiny that they're invisible to a normal microscope.
But they couldn't hide from the new test. Spotting those changes may
signal pancreatic cancer earlier, note Backman and colleagues.
Goal: Earlier Diagnosis

The new test isn't designed to diagnose pancreatic cancer by itself.
Instead, it's supposed to help doctors determine which patients need
further testing.

"We envision it as an initial screening test in patients who otherwise do
not have symptoms," says Backman.

The study is preliminary. Further tests are needed in larger groups of
patients, including those with noncancerous pancreatic conditions, note
the researchers.

Ultimately, the researchers hope to refine the technology to eliminate the
need for duodenal biopsies.

The researchers have partnered with a company called American BioOptics to
develop the technology, according to a National Science Foundation news
release.

SOURCES: Liu, Y. Clinical Cancer Research, Aug. 1, 2007; vol 13: pp
4392-4399. Vadim Backman, PhD, professor, biomedical engineering
department, Northwestern University. American Cancer Society: "How Many
People Get Pancreatic Cancer?"


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