# An Analysis of the mRNA Expression of Peripheral-Blood Stem and Progenitor Cell Markers in Pancreatic Neoplastic Disorders

## TL;DR

This study found that specific genes in blood cells are more active in pancreatic cancer patients, offering potential for non-invasive early detection.

## Contribution

The study identifies elevated mRNA expression of NANOG, CK19, and INS in blood as potential markers specific to pancreatic cancer.

## Key findings

- NANOG, CK19, and INS gene expression was significantly higher in pancreatic cancer patients compared to healthy controls.
- CK19 overexpression was linked to inflammation markers in pancreatic cancer patients.
- Neuroendocrine tumor patients did not show elevated expression of these genes.

## Abstract

Pancreatic cancer is one of the deadliest cancers, often diagnosed at an advanced stage when treatment options are limited and not effective. This study aimed to identify specific genetic markers in the blood that could help detect pancreatic cancer. We analyzed the expression of six genes in peripheral-blood mononuclear cells from the patients with pancreatic cancer, neuroendocrine tumors, and healthy individuals. The results showed that three genes—NANOG, CK19, and INS—were significantly elevated in patients with pancreatic cancer compared to healthy controls. These genes were not elevated in patients with neuroendocrine tumors, suggesting that this phenomenon may be specific to pancreatic cancer. Additionally, CK19 was associated with inflammation, a common characteristic of pancreatic cancer. These findings underscore the importance of studying mRNA expression in peripheral blood to enhance our understanding of pancreatic neoplasms and highlight the potential for using blood-based genetic markers to improve the detection of pancreatic cancer. With further validation, this approach could pave the way for less invasive and more accessible diagnostic tools.

Background: Our aim was to assess the expression profiles of the messenger RNA (mRNA) expression profiles of stem-cell genes (POU5F1, NANOG) and pancreatic progenitor genes (CK19, HES1, INS, PDX1) in peripheral-blood mononuclear cells (PBMCs) in selected neoplastic pancreatic diseases, such as cancer and neuroendocrine tumors, to identify neoplastic disease markers in the pancreas. Methods: In this study, 49 patients diagnosed with pancreatic neoplastic diseases (37 with cancer and 12 with neuroendocrine tumors) and 34 control patients, all of whom were hospitalized at a tertiary center, were enrolled. Venous blood samples were collected from the participants, and RNA was extracted from PBMCs. The mRNA expression levels of six stem-cell and pancreatic progenitor markers— POU5F1 (POU class 5 homeobox 1), NANOG, CK19 (keratin 19), HES1 (HES family bHLH transcription factor 1), INS (insulin), and PDX1 (pancreatic and duodenal homeobox 1)—were quantified via real-time quantitative PCR. The data were statistically analyzed to explore associations between gene-expression levels and various clinical, biochemical, and morphological parameters (including full blood count, Ca 19-9, weight, height, and BMI) via the Kruskal–Wallis test, Mann–Whitney U test, and Spearman rank correlation coefficient. Results: The results revealed that the expression of the gene associated with early stem cells, NANOG (median= 0.002, p = 0.03), as well as the genes encoding insulin INS (median = 0.004, p = 0.02) and CK19 (median 0.0003, p = 0.005), was significantly elevated in patients with pancreatic cancer. However, the gene-expression levels in patients with neuroendocrine tumors did not exhibit statistically significant differences compared to those observed in the control group. Additionally, no significant differences in gene expression were observed among patients at different stages of pancreatic cancer. Furthermore, CK19 overexpression was found to be positively correlated with inflammatory markers, specifically C-reactive protein (CRP) and WBC, in patients with pancreatic cancer. Conclusions: An elevated mRNA expression of specific stem and pancreatic progenitor genes (NANOG, INS, CK19) in PBMCs may serve as a potential markers for pancreatic cancer, reflecting the disease’s interplay with systemic inflammation.