Annals of Surgical Oncology

, Volume 26, Issue 3, pp 807–814 | Cite as

Thrombospondin-2 is a Highly Specific Diagnostic Marker and is Associated with Prognosis in Pancreatic Cancer

  • Hsuan-Yu Peng
  • Ming-Chu Chang
  • Chun-Mei Hu
  • Hwai-I Yang
  • Wen-Hwa Lee
  • Yu-Ting ChangEmail author
Pancreatic Tumors



Thrombospondin-2 (TSP-2) has been reported as an early diagnostic marker for pancreatic ductal adenocarcinoma (PDAC) in Caucasian populations. This study was designed to validateTSP-2 as a diagnostic marker in a large Taiwan cohort and to investigate the association of TSP-2 with the clinical outcomes of PDAC patients.


The serum TSP-2 levels in 263 PDAC patients and 230 high-risk individuals (HRIs) were measured via an enzyme-linked immunosorbent assay. The sensitivity, specificity, and accuracy of TSP-2 as a diagnostic marker to discriminating PDAC patients from HRIs and correlations between TSP-2 levels and prognosis of PDAC patients were analyzed.


Serum TSP-2 levels were significantly higher in patients with PDAC (44.90 ± 40.70 ng/ml) than in the HRIs (17.52 ± 6.23 ng/ml). At a level of ≥ 29.8 ng/ml, TSP-2 exhibited 100% specificity, 55.9% sensitivity, 100% positive predictive value (PPV), and 66.5% negative predictive value (NPV) for discriminating PDAC patients from HRIs. The Cox regression analysis showed that higher serum TSP-2 levels were significantly associated with poor outcomes in PDAC patients (hazard ratio = 1.54, 95% confidence interval = 1.143–2.086, P = 0.005). Combining the carbohydrate antigen 19-9 (CA19-9) (cutoff value of 62.0 U/ml) and TSP-2 (cutoff value of 29.8 ng/ml) levels yielded 98.7% specificity, 90.5% sensitivity, 98.8% PPV, and 90.1% NPV for discriminating patients with PDAC from HRIs.


TSP-2 is a highly specific diagnostic marker and an independent prognostic marker in patients with PDAC. A combined biomarker panel, including TSP-2 and CA19-9, may facilitate future PDAC screening.



Taiwan Pancreas Foundation; MOST106-2321-B-002-033 and 107-2321-B-002-013.

Author Contributions

Y-TC had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: H-YP, M-CC, C-MH, W-HL, and Y-TC. Acquisition, analysis, or interpretation of data: H-YP, M-CC, C-MH, H-IY, and Y-TC. Drafting of the manuscript: H-YP and Y-TC. Critical revision of the manuscript for important intellectual content: W-HL and Y-TC. Statistical analysis: H-YP, M-CC, and H-IY. Study supervision: W-HL and Y-TC.


All authors indicate no potential conflicts of interest.

Supplementary material

10434_2018_7109_MOESM1_ESM.docx (298 kb)
Supplementary material 1 (DOCX 298 kb)


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Copyright information

© Society of Surgical Oncology 2018

Authors and Affiliations

  • Hsuan-Yu Peng
    • 1
  • Ming-Chu Chang
    • 1
    • 2
  • Chun-Mei Hu
    • 3
  • Hwai-I Yang
    • 3
  • Wen-Hwa Lee
    • 3
    • 4
  • Yu-Ting Chang
    • 1
    • 2
    Email author
  1. 1.Department of Internal Medicine, College of MedicineNational Taiwan UniversityTaipeiTaiwan
  2. 2.Department of Internal MedicineNational Taiwan University HospitalTaipeiTaiwan
  3. 3.Genomics Research CenterAcademia SinicaTaipeiTaiwan
  4. 4.Taiwan Graduate Institute of Clinical MedicineChina Medical UniversityTaichungTaiwan

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