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Published on: April 18, 2025
Plasma cathepsin L: a prognostic marker for pancreatic cancer
Nidhi Singh1, Prasenjit Das1, Surabhi Gupta1
1Nidhi Singh, Surabhi Gupta, Vikas Sachdev, Siddhartha Srivasatava, Anoop Saraya, Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi 110029, India.
Aim:
To assess the prognostic significance of cathepsin L, a cysteine protease that degrades the peri-tumoral tissue, in patients with pancreatic cancer.
Methods:
Plasma samples from 127 pancreatic cancer patients were analyzed for cathepsin L levels by ELISA. Out of these patients, 25 underwent surgery and their paraffin-embedded tissue was analyzed for cathepsin L expression by immunohistochemistry. Survival of patients and clinicopathological parameters was correlated with cathepsin L expression in plasma and tissue using appropriate statistical analysis.
Results:
The mean (± SD) cathepsin L in plasma samples of pancreatic cancer patients was 5.98 ± 2.5 ng/mL that was significantly higher compared to the levels in healthy controls (3.83 ± 0.45) or chronic pancreatitis patients (3.97 ± 1.06). Using ROC curve, a cut-off level of 5.0 ng/mL was decided for survival analysis. Elevated plasma levels of cathepsin L were found to be associated with poor prognosis (P = 0.01) in multivariate analysis. The plasma levels of the protease decreased after surgery. Though no significant correlation was seen between plasma and tissue expression of this protease, a trend did emerge that high cathepsin L expression in tissue correlated with its high levels in plasma.
Conclusion:
Cathepsin L levels in plasma of pancreatic cancer patients may be used as a potential prognostic marker for the disease.
