A new molecular biomarker assay has been developed to identify lesions that are likely to progress into pancreatic cancers. Advances in imaging technology have enabled clinicians to visualize more presymptomatic lesions, both benign and potentially invasive. The real-time quantitative PCR assay will help clinicians determine which pancreatic lesions are high-grade requiring surgical intervention, from those that can be monitored for changes. The assay details are discussed in a paper published in the Journal of Molecular Diagnostics.
The assay measures telomere fusions, which occur when telomeres are shortened by the loss of their repeat sequences. This shortening can cause the telomere ends to fuse together leading to chromosomal instability and eventual cell death. "This is a major mechanism that contributes to the progression of many precancerous neoplasms to invasive cancers," said Dr. Michael Goggins, MD, Sol Goldman Professor of Pancreatic Cancer Research, Johns Hopkins University School of Medicine (Baltimore). "Telomere fusions can serve as a marker for predicting the presence of high-grade dysplasia and/or invasive cancer."
Three sets of patient samples were included in the study—lesions that were being removed, surgical cyst fluid samples, and normal pancreas tissue. The telomere fusion assay, which includes two rounds of PCR, was able to detect telomere fusions in more than half of the pancreatic cell lines. The fusions were often found in samples with more abnormal cells but not found in normal pancreas tissue or those with benign lesions. Similar findings were discovered in the cyst fluid samples.
"We have developed a simple molecular test to detect telomere fusions. This telomere fusion detection assay is a cheaper method for evaluating pancreatic cyst fluid than many next-generation sequencing approaches that are being evaluated for this purpose," noted Dr. Goggins.
It was also noted that the technology the assay uses to detect fusions and measure telomere length and activity is commonly found in many molecular diagnostic laboratories.