Simpson, Rachel E.Yip-Schneider, Michele T.Wu, HuangbingFan, HaoLiu, ZiyueKorc, MurrayZhang, JianjunSchmidt, C. Max2018-10-192018-10-192018Simpson, R. E., Yip-Schneider, M. T., Wu, H., Fan, H., Liu, Z., Korc, M., Zhang, J., & Schmidt, C. M. (2019). Circulating Thrombospondin-2 enhances prediction of malignant intraductal papillary mucinous neoplasm. American journal of surgery, 217(3), 425–428. https://doi.org/10.1016/j.amjsurg.2018.08.026https://hdl.handle.net/1805/17604Background IPMNs are cystic pancreatic lesions with variable malignant potential. Thrombospondin-2 (THBS2)—an endogenous, anti-angiogenic matrix glycoprotein—may modulate tumor progression. We hypothesized that circulating levels of THBS2 could aid in preoperative prediction of malignant IPMN. Methods Preoperative serum/plasma samples were procured from patients undergoing surgery. Circulating levels of THBS2 were measured (enzyme-linked immunosorbent assay) and compared to surgical pathology IPMN dysplastic grade. Results 164 patients underwent THBS2 testing (100 Low/Moderate-IPMN; 64 High-Grade/Invasive-IPMN). Circulating THBS2 (mean ± SD) was greater in High-Grade/Invasive-IPMN than Low/Moderate-grade IPMN (26.6 ± 12.7 ng/mL vs. 20.4 ± 8.2 ng/mL; P < 0.001). THBS2 (AUC = 0.65) out-performed CA19-9 (n = 144; AUC = 0.59) in predicting IPMN grade. The combination of THBS2, CA19-9, radiographic main-duct involvement, main-duct diameter, age, sex, and BMI (AUC 0.82; n = 137) provided a good prediction model for IPMN grade. Conclusion Circulating THBS2 is correlated with IPMN dysplasia grade. THBS2 alone did not strongly predict IPMN grade but rather strengthened prediction models for High-Grade/Invasive IPMN when combined with other clinical/biomarker data.enPublisher Policypancreatic cystintraductal papillary mucinous neoplasmpancreatic cancerArticle