High baseline soluble urokinase plasminogen activator receptor (suPAR) serum levels indicate adverse outcome after resection of pancreatic adenocarcinoma

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Sven H. Loosen - , University Hospital Aachen (Author)
  • Frank Tacke - , University Hospital Aachen (Author)
  • Niklas Püthe - , University Hospital Aachen (Author)
  • Marcel Binneboesel - , RWTH Aachen University, Central Hospital Bielefeld (Author)
  • Georg Wiltberger - , RWTH Aachen University (Author)
  • Patrick H. Alizai - , RWTH Aachen University (Author)
  • Jakob N. Kather - , University Hospital Aachen (Author)
  • Pia Paffenholz - , University of Cologne (Author)
  • Thomas Ritz - , RWTH Aachen University (Author)
  • Alexander Koch - , University Hospital Aachen (Author)
  • Frank Bergmann - , Heidelberg University  (Author)
  • Christian Trautwein - , University Hospital Aachen (Author)
  • Thomas Longerich - , RWTH Aachen University (Author)
  • Christoph Roderburg - , University Hospital Aachen (Author)
  • Ulf P. Neumann - , RWTH Aachen University (Author)
  • Tom Luedde - , University Hospital Aachen (Author)

Abstract

Surgical resection represents the only potentially curative therapy for patients with pancreatic adenocarcinoma (PDAC), an aggressive malignancy with a very limited 5-year survival rate. However, even after complete tumor resection, many patients are still facing an unfavorable prognosis underlining the need for better preoperative stratification algorithms. Here, we explored the role of the secreted glycoprotein soluble urokinase plasminogen activator receptor (suPAR) as a novel circulating biomarker for patients undergoing resection of PDAC. Serum levels of suPAR were measured by enzyme-linked immunosorbent assay (ELISA) in an exploratory as well as a validation cohort comprising a total of 127 PDAC patients and 75 healthy controls. Correlating with a cytoplasmic immunohistochemical expression of uPAR in PDAC tumor cells, serum levels of suPAR were significantly elevated in PDAC patients compared to healthy controls and patient with PDAC precursor lesions. Importantly, patients with high preoperative suPAR levels above a calculated cutoff value of 5.956 ng/ml showed a significantly reduced overall survival after tumor resection. The prognostic role of suPAR was further corroborated by uni-And multivariate Cox-regression analyses including parameters of systemic inflammation, liver and kidney function as well as clinico-pathological patients' characteristics. Moreover, high baseline suPAR levels identified those patients particularly susceptible to acute kidney injury and surgical complications after surgery. In conclusion, our data suggest that circulating suPAR represents a novel prognostic marker in PDAC patients undergoing tumor resection that might be a useful addition to existing preoperative stratification algorithms for identifying patients that particularly benefit from extended tumor resection.

Details

Original languageEnglish
Pages (from-to)947-955
Number of pages9
JournalCarcinogenesis
Volume40
Issue number8
Publication statusPublished - 22 Aug 2019
Peer-reviewedYes
Externally publishedYes

External IDs

PubMed 30805627

Keywords

Sustainable Development Goals

ASJC Scopus subject areas