The Role of Resolvin D1 in the Differential Diagnosis of Pancreatic Ductal Adenocarcinoma and Acute Pancreatitis: A Case-Control Study

Abstract

Background and Objectives: Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy characterized by a dense desmoplastic stroma with a poor prognosis. The aim of this study was to investigate whether resolvin (Rv) D1 could be used as a potential serum biomarker to discriminate between PDAC and acute pancreatitis (AP). Materials and Methods: In total, 67 patients were enrolled in the present study, including 21 patients with resectable PDAC, 23 patients with metastatic PDAC, 23 patients with AP, and a control group of 21 healthy individuals. RvD1 levels of PDAC patients were also analyzed through ELISA at the 6th postoperative month. Results: The mean RvD1 was 1169.24 +/- 285.99 in the control group, 885.04 +/- 134.25 in the AP group, 728.57 +/- 140.1 in the PDAC group, and 670.09 +/- 105.6 in the metastatic pancreatic cancer (PC) group. RvD1 was significantly lower in PDAC and metastatic PC groups compared to controls and patients with AP, while it was significantly lower in patients with AP compared to the control groups. Postoperative RvD1 levels of patients with PDAC 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 PDAC from metastatic PC with 84.1% sensitivity and 81.8% specificity. Conclusions: Serum RvD1 is a new biomarker for the detection of PDAC. Serum RvD1 may provide an important diagnostic contribution in clinical practice to predict PDAC. Serum RvD1 levels were found to be predictive with high sensitivity and specificity in differentiating PDAC from metastatic PC. However, it was concluded that serum RvD1 levels cannot be used as a detection marker to differentiate PDAC from AP. RvD1 could be a representative agent of a new class of drugs to be proposed for innovative treatment of AP and PDAC. Our future study will investigate whether RvD1 can be a marker to differentiate from chronic pancreatitis.