Table 1.
Blood biomarkers with possible clinical use in PDAC
| Blood biomarkers | Potential clinical use in PDAC |
|---|---|
| Proteins | |
| CA 19.9 | Prognosis |
| Disease monitoring in clinical practice | |
| It is not used for diagnosis in clinical practice due to a low sensitivity (78%) and specificity (83%) | |
| CEA | Prognosis |
| ADH and MIC-1 | The addition of ADH and MIC-1 to CA 19.9 significantly improved the efficacy of diagnosis (AUC 0.89) |
| SPARC/Osteonectin | Detection of early stage (sensitivity 84.6%, specificity 87.5%) |
| Panel of TIPM1, LRG1 and CA 19.9 | Detection of early stage (sensitivity 84.9%, specificity 95%, AUC 0.949) |
| IGFBP3 | Detection of early stage (sensitivity 76.3%, specificity 70.7%); increased effectiveness as a compensatory biomarker for CA 19.9 (AUC 0.90) |
| apoII-ATQ/AT | Decline significantly in PDAC; combined with CA 19.9 as a sensitivity of 95.4% and specificity of 98.3% |
| Metabolites | |
| Five-metabolite panel (acetylspermidine, diacetylspermine, an indole derivate, and two lysophosphatidylcholines) | Detection of early stage: performance was significantly improved when combined with the previously validated protein panel of CA 19.9, LRG1, and TIMP1 (AUC 0.924) |
| Circulating tumor DNA | |
| KRAS mutant ctDNA | Diagnosis (sensitivity 47%, specificity 87%); combination with CA 19.9 had a sensitivity of 98% and specificity of 77% |
| Disease monitoring in advanced PDAC patients under chemotherapy | |
| Prognosis | |
| cfDNA hypermethylation | Diagnosis: ZNF154 cfDNA methylation discriminated cases from healthy donor plasma; integrated model of 5mC and 5hmC (AUC 0.997) |
| Prognosis | |
| Circulating tumor cells | |
| CK-20, CEA, C-MET, and the human telomerase reserve transcriptase mRNA expression | Diagnosis (CK-20: sensitivity 84%, specificity 93%; CEA: sensitivity 80%, specificity 100%; C-MET: sensitivity 80%, specificity 100%; human telomerase reverse transcriptase: sensitivity 100%, specificity 100%) |
| Disease monitoring | |
| CEA mRNA expression | Prognosis |
| CTC numbers | Disease monitoring |
| Prognosis | |
| Circulating miRNA | See Table 2 |
| Circulating exosomes | |
| Circulating exosomes positive for GPC1 | Diagnosis |
| Disease monitoring | |
| Prognosis | |
| KRAS mutations from exosomes | Diagnosis: identified in 66.7%, 80%, and 85% of patients with localized, locally advanced, and metastatic disease, respectively |
| Prognosis | |
| MUC5AC | Diagnosis: can predict the presence of invasive carcinoma within IPMN (sensitivity 82%, specificity 100%) |
CA 19.9 Carbohydrate antigen 19.9, CEA Carcinoembryonic antigen, AHD Alcohol dehydrogenase, MIC-1 Circulating macrophage inhibitory cytokine, SPARC Secreted protein acidic and rich in cysteine, TIPM1 tissue inhibitor of metalloproteinase-1, LRG1 leucine-rich alpha-2 glycoprotein 1, IGFBP3 Insulin-like growth factor-binding protein 3, apoII-ATQ/AT C-terminal truncations of the circulating apolipoprotein
AII homo-dimer—ctDNA circulating tumor DNA, cfDNA cell-free DNA, 5mC 5-methylcytosine, 5hmC 5-hydroxymethylcytosine, GPC1 glypican-1