According to a new study, fecal microbiota-based markers could predict pancreatic ductal adenocarcinoma (PDAC) with a high level of accuracy and specificity, possibly facilitating diagnosis at an early stage.

Peer Bork, of the European Molecular Biology Laboratory in Heidelberg, Germany, and colleagues suggested that fecal microbiome-based detection of PDAC could provide a non-invasive and cost-effective approach to early PDAC diagnosis. Based on a set of 27 microbial species, fecal metagenomic classifiers could detect patients with PDAC with an accuracy of 0.84 area under the receiver operating characteristic curve (AUROC), and were better than saliva-based classifiers. When combined with serum levels of CA 19-9, this panel of classifiers had improved performance with an AUROC of 0.94. 

Researchers obtained samples of saliva, feces and normal and tumor tissue from the pancreas, of 136 patients at two Spanish hospitals. Fifty seven among them were newly diagnosed with PDAC, 29 with chronic pancreatitis (a risk factor for pancreatic cancer), and 50 same-hospital inpatient controls. After controlling the clinical and demographic variables, they constructed a molecular signature of 27 stool-derived microbes that could differentiate between cases of pancreatic cancer, chronic pancreatitis, and controls. They also evaluated the microbiome-based models in two validation scenarios. The prediction accuracy of the models was first confirmed in an independent German PDAC population and then validated against available data from 25 studies across 18 countries. (Medpage Today, March 10, 2022)