The relationship of serum resolvin D1 with pancreatic ductal adenocarcinoma

ABSTRACT The Relationship of Serum Resolvin D1 with Pancreatic Ductal Adenocarcinoma Introduction and Objective Despite new techniques and treatments and multidisciplinary approaches, pancreatic cancer is a disease with high mortality and morbidity rates due to its aggressive course and poor prognosis. Although many risk factors such as certain genetic syndromes, age, smoking, diabetes, alcohol, and obesity, and various molecular pathways associated with pancreatic cancer have been identified, the exact mechanisms that cause pancreatic cancer remain unclear. Therefore, prevention, early diagnosis, and rapid treatment are clinically challenging. Recent studies have reported that resolvins (Rvs), a family of lipid mediators derived from dietary omega-3, play significant roles in inhibiting carcinogenesis. Therefore, in this study, which is an original thesis, we aimed to diagnostically evaluate serum RvD1 levels, a bioactive lipid, in pancreatic ductal adenocarcinomas (PDAC). Materials and Methods In this thesis study, 21 patients diagnosed with resectable PDAC, 23 patients diagnosed with metastatic PDAC, 23 patients diagnosed with acute pancreatitis (AP), 21 patients who came for follow-up at the 6th month after pancreatic cancer surgery (pathology result was PDAC) and 21 healthy volunteers without any additional disease who applied to the outpatient clinic for routine control were included. Serum RvD1 levels, CA19-9, CEA and amylase levels, were measured by Enzyme-Linked Immunosorbent Assay (ELISA) technique in the morning fasting blood samples of healthy volunteers and patient groups. Post-operative serum RvD1 levels were also measured in the PDAC group. In statistical analyses, p<0.05 was considered significant. Results In this thesis study, a significant difference was found between the patient groups in terms of RvD1. The mean RvD1 was 1169.24±285.99 in the healthy group, 885.04±134.25 in the pancreatitis group, 728.57±140.1 in the pancreatic cancer group and 670.09±105.6 in the metastatic pancreatic cancer group. RvD1 was significantly lower in pancreatic cancer and metastatic pancreatic cancer groups compared to healthy patient and patients with pancreatitis, while it was significiantly lower in patients with pancreatitis compared to healthy group. Postoperative RvD1 levels of patients with pancreatic cancer were significantly higher than preoperative levels (728.57±140.1 vs 885.43±275.57). In the ROC analysis, when the cut-off value for serum RvD1 level was 825 ng/L, it was found to predict pancreatic cancer from metastatic pancreatic cancer with 84.1% sensitivity and 81.8% specificity. Conclusion Decreased serum RvD1 levels may trigger pancreatic carcinogenesis. Serum RvD1 can provide significant diagnostic contributions in clinical practise predict PDAC. In particular, serum RvD1 levels were found to be predictive with high sensitivity and specificity in differentiating pancreatic cancer from metastatic pancreatic cancer. However, it was concluded that serum RvD1 levels cannot be used as a diagnostic marker to differentiate pancreatic cancer from acute pancreatitis. However, it suggest that enhancing endogenous clearance of tumor cell debris by RvD1 is a novel therapeutic target that may complement cytotoxic cancer therapies. KEYWORDS: pancreatic cancer, acute pancreatitis, inflammation, marker, resolvin D1