Use of Autoreactive Antibodies in Blood of Patients with Pancreatic Intraductal Papillary Mucinous Neoplasms (IPMN) for Grade Distinction and Detection of Malignancy

SIMPLE SUMMARY: Risk stratification via biomarkers used with imaging could support predicting high-risk pancreatic intraductal papillary mucinous neoplasms (IPMN) with malignant potential. We explored the presence of autoreactive antibodies in the blood of patients with IPMN of different grades of dysplasia, including IPMN with associated invasive carcinoma and early-stage pancreatic ductal adenocarcinoma (PDAC), to identify signatures of early malignancy. Multivariate predictive models retained 14 proteins as potential biomarkers for discrimination between all disease classes. The integration of the autoreactive-antibody panel with clinical variables may aid in risk stratification of high-risk IPMN patients, which would subsequently improve clinical management. ABSTRACT: (1) Background: A reliable non-invasive distinction between low- and high-risk pancreatic intraductal papillary mucinous neoplasms (IPMN) is needed to effectively detect IPMN with malignant potential. This would improve preventative care and reduce the risk of developing pancreatic cancer and overtreatment. The present study aimed at exploring the presence of autoreactive antibodies in the blood of patients with IPMN of various grades of dysplasia. (2) Methods: A single-center cohort was studied composed of 378 serum samples from patients with low-grade IPMN (n = 91), high-grade IPMN (n = 66), IPMN with associated invasive cancer (n = 30), pancreatic ductal adenocarcinoma (PDAC) stages T1 (n = 24) and T2 (n = 113), and healthy controls (n = 54). A 249 full-length recombinant human protein microarray was used for profiling the serum samples. (3) Results: 14 proteins were identified as potential biomarkers for grade distinction in IPMN, yielding high specificity but mediocre sensitivity. (4) Conclusions: The identified autoantibodies are potential biomarkers that may assist in the detection of malignancy in IPMN patients.