Tumor-educated platelets as liquid biopsy tool in pancreatic and biliary tract cancer: integrin alpha 2b (ITGA2B) and selectin P (SELP)

Abstract

Background
Malignant tumors of the pancreas and biliary tract are highly aggressive cancers with a poor prognosis, as most patients are diagnosed at late stages and are associated with unfavourable outcomes. When platelets interact with tumor cells or tumor-derived molecules, their RNA profile is altered, giving rise to what are known as tumor-educated platelets. Since Integrin alpha 2B (ITGA2B) and selectin P (SELP) are tumor-related genes, our work focussed on finding RNAs for these genes on tumor-educated blood platelets.


Study design and methodology
This cross-sectional study included 60 newly diagnosed cancer patients (26 with pancreatic cancer and 34 with biliary cancer). The expression levels of the ITGA2B and SELP genes were determined using PCRs in platelet samples from 60 cancer patients and 30 healthy controls.


Results

Platelets ITGA2B levels were significantly lower in pancreatic cancer patients in comparison to healthy controls (
P
<0.001) and in biliary cancer patients in comparison to healthy controls (
P
=0.004). The diagnostic accuracy of ITGA2B was area under the curve of 0.750 [95% confidence interval (CI), 0.647–0.835], sensitivity of 53.3% and specificity of 96.7%. There was no significant difference in platelet SELP levels between cancer patients and healthy controls.



Conclusion
Platelet ITGA2B was significantly downregulated in both pancreatic and biliary cancer patients compared with healthy controls with high specificity.