Serine protease inhibitor, kazal type1 (SPINK1) level in pancreas cancer

INTRODUCTION: Pancreatic cancer is a highly lethal disease. Most patients with pancreatic cancer remain asymptomatic until the disease reaches an advanced stage. There is no standard programme for screening of pancreatic cancer. There is need for spesific serum markers for diagnosis of pancreatic cancer. SPINK is a protease inhibitor with potential inhibitory effects on tissue degradation. In serum, increased levels have been associated with adverse prognosis in different forms of cancer. We studied the clinical-pathologic association and significance of serum levels of SPINK1 in pancreatic cancer patients. AİMS&METHODS: We aimed to investigate the importance of serum SPINK1 levels in the diagnosis and treatment of pancreatic cancer. Sixty two patients with pancreatic adenocarcinoma and 76 healthy controls were included in the study. Age, gender, family history, age of diagnosis, disease stage, clinical symptoms and biochemical parameters of the patients were evaluated. Serum SPINK1 levels were measured by ELISA. RESULTS: Pancreatic cancer patients has significantly higher levels of serum SPINK1 levels then controls(48.3±29.3 vs25.3±15.4ng/ml, p<0.001). The cut off value of serum SPINK1 levels over 25 ng/ml has 71% sensitivity and 61% specificity for diagnosis of pancreatic cancer(p<0.001, AUC 0.71). Serum SPINK1 levels was not correlated with serum CA19-9 levels and other biochemical paremeters. Serum SPINK1 levels were found to be low in patients with diabetes mellitus. Serum SPINK1 levels were not affected by the stage of the disease, but were even higher in the early stages. As the tumor size increased, serum SPINK1 level increased. There was no significant difference in SPINK1 levels in patients with and without metastasis. CONCLUSION: Serum SPINK1 level has high sensitivity and specificity in the diagnosis of pancreatic ductal adenocarcinoma. However, it is not an indicator that can be used to determine the prognosis of the disease. Keywords: SPINK1; cancer; pancreas