Pancreatic cancer has the worst prognosis among all cancers. Cancer screening of body fluids may improve the survival time prognosis of patients, who are often diagnosed too late at an incurable stage. Several studies report the dysregulation of lipid metabolism in tumor cells, suggesting that changes in the blood lipidome may accompany tumor growth. Here we show that the comprehensive mass spectrometric determination of a wide range of serum lipids reveals statistically significant differences between pancreatic cancer patients and healthy controls, as visualized by multivariate data analysis. Three phases of biomarker discovery research (discovery, qualification, and verification) are applied for 830 samples in total, which shows the dysregulation of some very long chain sphingomyelins, ceramides, and (lyso)phosphatidylcholines. The sensitivity and specificity to diagnose pancreatic cancer are over 90%, which outperforms CA 19-9, especially at an early stage, and is comparable to established diagnostic imaging methods. Furthermore, selected lipid species indicate a potential as prognostic biomarkers.

3rd Department of Internal Medicine 1st Faculty of Medicine Charles University Prague Czech Republic

3rd Faculty of Medicine Charles University Prague Czech Republic

Clinic of Comprehensive Cancer Care Masaryk Memorial Cancer Institute Brno Czech Republic

Department of Analytical Chemistry Faculty of Chemical Technology University of Pardubice Pardubice Czech Republic

Department of Analytical Chemistry University of Vienna Vienna Austria

Department of Biochemistry Yong Loo Lin School of Medicine National University of Singapore Singapore Singapore

Department of Immunochemistry Diagnostics University Hospital in Pilsen Pilsen Czech Republic

Department of Oncology Faculty of Medicine and Dentistry Palacký University and University Hospital Olomouc Czech Republic

Faculty of Medicine Masaryk University Brno Czech Republic

Institute of Clinical Chemistry and Laboratory Medicine University Hospital of Regensburg Regensburg Germany

Palacký University Olomouc Institute of Molecular and Translational Medicine Olomouc Czech Republic

Research Centre for Applied Molecular Oncology Masaryk Memorial Cancer Institute Brno Czech Republic

Research Unit for Rare Diseases Department of Pediatrics and Inherited Metabolic Disorders 1st Faculty of Medicine Charles University and General University Hospital Prague Prague Czech Republic

Singapore Lipidomics Incubator Life Sciences Institute National University of Singapore Singapore Singapore

Tecnometrix Ciutadella De Menorca Spain

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