Chronic Inflammation Induced by Escherichia coli Blood Infections as a Risk Factor for Pancreatic Cancer Progression.

[BACKGROUND AND AIM] Pancreatic cancer exhibits a high level of aggressiveness and is associated with a high mortality rate. The study comprised 50 patients with pancreatic cancer and 50 healthy family members and friends. The main goal is to explore the biomarkers carbohydrate antigen 19-9 (CA19-9), amylase, procalcitonin (PCT), and interleukin 6 (IL-6), confirm the presence of Escherichia coli infection in the patients' bloodstreams, and evaluate the effect of chronic inflammation on the progression of pancreatic cancer.

[METHODS] The CA19-9, IL-6, and PCT levels of the control and patient groups were measured with Roche-Cobas C411, and their amylase levels were measured with Cobas C311. In addition, a VITEK2 Compact system was utilized to detect E. coli blood infection, and the antibiotic susceptibility of the patients was evaluated.

[RESULTS] The higher PCT and IL-6 levels (P < 0.0001*) of the patients with pancreatic cancer indicated chronic inflammation promoting tumor growth, invasion, and metastasis, and high levels of CA19-9 (P < 0.0001*) indicated pancreatic cancer. Moreover, tumor damage and ductal blockage lowered amylase levels in patients with pancreatic cancer. In addition, bloodstream infections in patients with pancreatic cancer were mostly caused by E. coli (34/50, 68%), and the isolates were resistant to ciprofloxacin (100%). Approximately, 94.11% were resistant to levofloxacin and ceftazidime, whereas only 26.4% were resistant to sulfamethoxazole/ trimethoprim. A total of 29 isolates (85.2%) were multidrug resistant.

[CONCLUSION] Chronic inflammation from E. coli infections is crucial to pancreatic cancer progression. Inflammatory indicators, including PCT and IL-6, and diagnostic biomarkers, including CA19-9 and amylase, reveal malignancy growth and bacterial infections that complicate treatment. Patients with positive PCT and IL-6 results were likely to have positive blood cultures and E. coli infections. These biomarkers should be utilized alongside other diagnostic imaging and biopsy methods to improve the detection of pancreatic cancer and screening for bacterial infections.