{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T16:26:19Z","timestamp":1791649579828,"version":"4.3.4"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>We investigated the clinical utility of the apolipoprotein A2 isoform index (apoA2\u2010i index), a novel tumor marker for pancreatic cancer, in clinical practice, particularly for CA19\u20109\u2010negative pancreatic cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between May 2024 and July 2025, patients who underwent abdominal computed tomography (CT) for the differential diagnosis of pancreatic diseases had their CEA, CA19\u20109, and apoA2\u2010i indexes measured. We evaluated the sensitivity and specificity for pancreatic cancer and analyzed the relationship between the apoA2\u2010i index and pancreatic atrophy or main pancreatic duct dilatation on CT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 115 patients were included: 38 with pancreatic cancer, 47 with intraductal papillary mucinous neoplasms (IPMNs), and 30 with other conditions. The median age was 72.0\u2009years, and 55 patients (47.8%) were male. The sensitivity of apoA2\u2010i index for pancreatic cancer was 65.8%, while the specificity was 85.7%. The combined use of CA19\u20109 and the apoA2\u2010i index increased sensitivity to 78.9% (specificity, 81.8%). Among 17 patients with CA19\u20109\u2010negative pancreatic cancer, 9 (52.9%) tested positive for the apoA2\u2010i index. The positive rates for stage 0\/I pancreatic cancer were 12.5% for CA19\u20109 and 62.5% for the apoA2\u2010i index. Regarding CT findings, the apoA2\u2010i index significantly decreased with the progression of pancreatic atrophy (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.027) and was also significantly lower in patients with pancreatic duct dilatation (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The apoA2\u2010i index can detect CA19\u20109\u2010negative pancreatic cancer, and the combination of the apoA2\u2010i index with CA19\u20109 enhances diagnostic performance in clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jgh3.70375","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T21:26:55Z","timestamp":1773005215000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical Utility of the Apolipoprotein\n                    <scp>A2<\/scp>\n                    Isoform Index as a Tumor Marker for Pancreatic Cancer"],"prefix":"10.1002","volume":"10","author":[{"given":"Takashi","family":"Hoshino","sequence":"first","affiliation":[{"name":"Department of Gastroenterology NHO Takasaki General Medical Center  Takasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5349-0109","authenticated-orcid":false,"given":"Masafumi","family":"Mizuide","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Saitama Medical University International Medical Center  Hidaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhei","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology NHO Takasaki General Medical Center  Takasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidetoshi","family":"Yasuoka","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology NHO Takasaki General Medical Center  Takasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0663-0102","authenticated-orcid":false,"given":"Atsushi","family":"Naganuma","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology NHO Takasaki General Medical Center  Takasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3656-285X","authenticated-orcid":false,"given":"Takeshi","family":"Hatanaka","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Gunma Saiseikai Maebashi Hospital  Maebashi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0224-7093","authenticated-orcid":false,"given":"Satoru","family":"Kakizaki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology NHO Takasaki General Medical Center  Takasaki Japan"},{"name":"Department of Clinical Research NHO Takasaki General Medical Center  Takasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4128-9990","authenticated-orcid":false,"given":"Shomei","family":"Ryozawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Saitama Medical University International Medical Center  Hidaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(25)00261-2"},{"key":"e_1_2_8_3_1","unstructured":"National Cancer Center Japan \u201cNationwide Cancer Mortality Data (1958\u20132024) \u201daccessed November 10 2025 https:\/\/ganjoho.jp\/reg_stat\/index.html."},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.08.2644"},{"key":"e_1_2_8_6_1","first-page":"350","article-title":"The Clinical Utility of the CA 19\u20109 Tumor\u2010Associated Antigen","volume":"85","author":"Steinberg W.","year":"1990","journal-title":"American Journal of Gastroenterology"},{"key":"e_1_2_8_7_1","first-page":"5501","article-title":"Relationship of Carbohydrate Antigen 19\u20109 and Lewis Antigens in Pancreatic Cancer","volume":"47","author":"Tempero M. 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