Feasibility of Early Diagnosis of Pancreatic Cancer using reagent for analyzing purine metabolite (Hypoxanthine, Xanthine) in urine

Abstract Introduction: Pancreatic cancer (PC) is a leading cause of cancer-related mortality, and is often diagnosed at an advanced stage. Early detection is crucial for improving patient outcome. Current biomarkers like CA 19-9 have limitations in terms of sensitivity and specificity. This study investigated the potential of the urinary purine metabolites hypoxanthine and xanthine as biomarkers for early PC detection. Methods: This single-center, non-blinded clinical trial included 120 participants (60 patients with PC and 60 healthy controls). Patients aged 18-85 years, scheduled for curative PC surgery were recruited. Urine samples were collected preoperatively and analyzed using a purine metabolome analysis kit developed by CUBEBIO. The study assessed the concentrations of hypoxanthine and xanthine and compared them with CA 19-9 levels. Statistical analyses were conducted using SPSS, with significance set at p < 0.05. Results: PC patients had significantly higher mean ages (65.63 ± 10.58 years) and lower BMI (22.55 ± 3.19 kg/m²) than controls (46.62 ± 13.34 years and 24.94 ± 3.56 kg/m², respectively). Urinary hypoxanthine and xanthine levels were significantly lower in patients with PC (0.136 ± 0.0821) than in controls (0.292 ± 0.1208), with a p-value of <0.001. The diagnostic method showed an area under the curve (AUC) of 0.850, with a sensitivity of 87.9% and specificity of 71.1%. Urinary purine metabolites outperformed CA 19-9 for early-stage PC detection. Conclusion: Urinary hypoxanthine and xanthine are promising biomarkers for early PC detection, offering a noninvasive, cost-effective diagnostic tool with higher sensitivity and specificity than CA 19-9. These findings support further research to validate and refine this diagnostic approach, potentially improving the early detection and patient outcomes in pancreatic cancer.