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. 2022 May 1;13(5):e00473.
doi: 10.14309/ctg.0000000000000473.

Serum Syndecan-1: A Novel Biomarker for Pancreatic Ductal Adenocarcinoma

Doron Yablecovitch  1   2 , Shomron Ben-Horin  1   2 , Orit Picard  1   2 , Miri Yavzori  1   2 , Ella Fudim  1   2 , Moshe Nadler  1   2 , Idan Levy  1   2 , Emad Sakhnini  1   2 , Alon Lang  1   2 , Tal Engel  1   2 , Maor Lahav  1   2 , Talia Saker  2   3 , Sandra Neuman  1   2 , Limor Selinger  1   2 , Revital Dvir  1   2 , Maria Raitses-Gurevich  2   4 , Talia Golan  2   4 , Ido Laish  1   2
Affiliations

Serum Syndecan-1: A Novel Biomarker for Pancreatic Ductal Adenocarcinoma

Doron Yablecovitch et al. Clin Transl Gastroenterol. .

Abstract

Introduction: Syndecan-1 (SDC1) has multiple functions in tumorigenesis in general and specifically in pancreatic cancer. We aimed to evaluate SDC1 as a diagnostic and prognostic biomarker in patients with pancreatic ductal adenocarcinoma (PDAC).

Methods: In this case-control study, patients newly diagnosed with a biopsy-proven PDAC were enrolled alongside healthy individuals in a derivation-validation cohort design. Serum SDC1 was measured by enzyme-linked immunoassay. The diagnostic accuracy of SDC1 levels for diagnosing PDAC was computed. A unified cohort enriched with additional early-stage patients with PDAC was used to evaluate the association of SDC1 with survival outcomes and patient characteristics.

Results: In the derivation cohort, serum SDC1 levels were significantly higher in patients with PDAC (n = 39) compared with healthy controls (n = 20) (40.1 ng/mL, interquartile range 29.8-95.3 vs 25.6 ng/mL, interquartile range 17.1-29.8, respectively; P < 0.001). The receiver operating characteristic analysis area under the curve was 0.847 (95% confidence interval 0.747-0.947, P < 0.001). These results were replicated in a separate age-matched validation cohort (n = 38 PDAC, n = 38 controls; area under the curve 0.844, 95% confidence interval 0.757-0.932, P < 0.001). In the combined-enriched PDAC cohort (n = 110), using a cutoff of 35 ng/mL, the median overall 5-year survival between patients below and above this cutoff was not significantly different, although a trend for better survival after 1 year was found in the lower level group (P = 0.06). There were 12 of the 110 patients with PDAC (11%) who had normal CA 19-9 in the presence of elevated SDC1.

Discussion: These findings suggest serum SDC1 as a promising novel biomarker for early blood-based diagnosis of pancreatic cancer.

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Conflict of interest statement

Guarantor of the article: Doron Yablecovitch, MD.

Specific author contributions: Talia Golan, MD, and Ido Laish, MD contributed equally to this work. D.Y.: conceptualization and writing; S.B-H.: supervision and methodology; I.L.: supervision and writing; T.G.: supervision, methodology, and data acquisition; O.P., M.Y., and E.F: methodology and data acquisition; M.N., I.L., E.S., A.L., and M.L.: data acquisition; T.S.: visualization; S.N., L.S., and R.D.: methodology; M.R-G.: data acquisition, reviewing, and editing. All the authors involved in critical revision of the manuscript for important intellectual content and approved the final version of the manuscript.

Financial support: None to report.

Potential competing interests: None to report.

Figures

Figure 1.
Figure 1.
(a) Box-plot representation of median serum syndecan-1 levels in patients with pancreatic ductal adenocarcinoma (PDAC) vs healthy controls (derivation cohort). (b) Box-plot representation of median serum syndecan-1 levels in patients with PDAC vs healthy controls (validation cohort).
Figure 2.
Figure 2.
(a) Receiver operating characteristic curve of the diagnostic accuracy of serum syndecan-1 to discriminate between healthy controls and patients with pancreatic ductal adenocarcinoma (derivation cohort). (b) Receiver operating characteristic curve of the diagnostic accuracy of serum syndecan-1 to discriminate between healthy controls and patients with pancreatic ductal adenocarcinoma (validation cohort).
Figure 3.
Figure 3.
(a) Box-plot representation of median serum syndecan-1 levels at diagnosis in patients with pancreatic ductal adenocarcinoma according to tumor stages compared with healthy controls. Serum syndecan-1 levels were not significantly different among the different stage groups. (b) Box-plot representation of median serum syndecan-1 levels at diagnosis in patients with metastatic pancreatic ductal adenocarcinoma (PDAC) compared with nonmetastatic patients with PDAC and healthy controls.
Figure 4.
Figure 4.
Kaplan-Meier curve of overall survival among patients with serum syndecan-1 levels of 35 ng/mL or more at baseline vs those with baseline serum syndecan-1 levels lower than 35 ng/mL. Log-rank test for equality of survivor functions, P-value = 0.15.
See this image and copyright information in PMC

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