Diagnostic Role of Pituitary Adenylated Cyclase Activating Polypeptide-38 in Multiple Myeloma | ||
| Zagazig University Medical Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 26 August 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/zumj.2025.404152.4055 | ||
| Authors | ||
| Saad El osh1; Ayman Fathy Arafa2; Marwa Mohammed Esawy3; Ahmed Mokhtar4; Arwa Osama El-Bayaa* 5; Maha Mahmoud Hamed Sakr4 | ||
| 1Professor of Clinical Pathology department, Faculty of Medicine, Zagazig University, Egypt | ||
| 2Professor of Internal Medicine department, Faculty of Medicine, Zagazig University, Egypt | ||
| 3Assistant Professor of Clinical Pathology department, Faculty of Medicine, Zagazig University, Egypt | ||
| 4Lecturer of Clinical Pathology department, Faculty of Medicine, Zagazig University, Egypt | ||
| 5Department of Clinical Pathology, Faculty of Human Medicine – Zagazig University, Egypt | ||
| Abstract | ||
| Background: Multiple myeloma (MM) is a cancerous growth of plasma cells that primarily affects the elderly. It represents 10% of hematological malignancies nowadays. The research reveals that pituitary adenylated cyclase activating polypeptide-38 (PACAP-38) with anti-inflammatory, antioxidant and anti-tumor effects. It influences complex cytokines in bone marrow microenvironment altered by malignant myeloma cells. This study aimed to investigate the variations in PACAP-38 levels in MM cases to explore its clinical significance as a novel biomarker in MM. Methods: A case-control study was conducted, including 38 cases (20 males and 18 females) and 38 controls (22 males and 16 females). The mean age of the cases was 57.16 ± 9.55 years and control was 55±7.33. PACAP-38 levels were measured using the enzyme-linked immunosorbent assay (ELISA) technique. Results: MM patients had a significantly lower PACAP-38 level when compared to the control group at diagnosis (223.97±76.99ng/L and 470.75±149.99, respectively). PACAP-38 levels showed significant positive correlations with hemoglobin, total leukocytes count, platelet count, and albumin. While it showed a negative correlation with creatinine, B2-microglobulin, TP, calcium, LDH, and the percentage of plasma cells. Regarding the international staging system (ISS), 42.1% had ISS I, 42.1% had ISS II, and 15.8% had ISS III. PACAP-38 had a decreasing trend with the progress of the ISS stages. PACAP-38 showed a specificity of 89.47% and a sensitivity of 94.7% for MM prediction. Conclusion: This study indicates that PACAP-38 can be used as a valuable, non-invasive and complementary biomarker in the diagnosis and staging of MM | ||
| Keywords | ||
| Diagnostic; Marker; Multiple myeloma; PACAP-38 | ||
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