Serum N-glycome analysis reveals pancreatic cancer disease signatures

Background &Aims Pancreatic ductal adenocarcinoma (PDAC) is an aggressive cancer type with loco-regional spread that makes the tumor surgically unresectable. Novel diagnostic tools are needed to improve detection of PDAC and increase patient survival. In this study we explore serum proteinN-glycan profiles from PDAC patients with regard to their applicability to serve as a disease biomarker panel. Methods Total serumN-glycome analysis was applied to a discovery set (86 PDAC cases/84 controls) followed by independent validation (26 cases/26 controls) using in-house collected serum specimens. ProteinN-glycan profiles were obtained using ultrahigh resolution mass spectrometry and included linkage-specific sialic acid information.N-glycans were relatively quantified and case-control classification performance was evaluated based on glycosylation traits such as branching, fucosylation, and sialylation. Results In PDAC patients a higher level of branching (OR 6.19,P-value 9.21 x 10(-11)) and (antenna)fucosylation (OR 13.27,P-value 2.31 x 10(-9)) ofN-glycans was found. Furthermore, the ratio of alpha 2,6- vs alpha 2,3-linked sialylation was higher in patients compared to healthy controls. A classification model built with three glycosylation traits was used for discovery (AUC 0.88) and independent validation (AUC 0.81), with sensitivity and specificity values of 0.85 and 0.71 for the discovery set and 0.75 and 0.72 for the validation set. Conclusion SerumN-glycome analysis revealed glycosylation differences that allow classification of PDAC patients from healthy controls. It was demonstrated that glycosylation traits rather than singleN-glycan structures obtained in this clinical glycomics study can serve as a basis for further development of a blood-based diagnostic test.Surgical oncolog