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. 2022 Jan 10;71(10):2043–2068. doi: 10.1136/gutjnl-2021-324994

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© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Circulating agrin-positive EVs are a biomarker of disease progression and predict response to treatment in patients with PDAC. (A) Presurgery and postsurgery analysis of the percentage of circulating agrin-positive EVs coupled to beads in the serum of PDAC patients (n=19, paired t-test; *p<0.05). (B, C) Prechemotherapy and postchemotherapy analyses of the percentage of circulating agrin-positive EVs coupled to beads in the serum of patients with PDAC treated with all regimens (B) (n=24, paired t-test; *p<0.05) and folfirinox-based regimens (C) (n=13, paired t-test; **p<0.01). (D) Correlation between the percentage of circulating CD133-positive EVs coupled to beads and the log10 of the percentage of agrin-positive EVs coupled to beads in the serum of patients with PDAC (n=106, Spearman r=0.6272). (E) Analysis of the percentage of circulating agrin-positive EVs coupled to beads in the serum of three patients with PDAC throughout time. QRT, chemotherapy, ŦAborted surgery due to non-resectable tumour. (F) Receiver operating curve analysis for the percentage of agrin-positive (red), CD133-positive (blue), and combination of agrin-positive and CD133-positive (purple) EVs coupled to beads and CA19-9 (green) in the serum of patients with PDAC not submitted to surgery (n=22 in circulating agrin-positive and CD133-positive EVs coupled to beads analysis and n=20 in CA19-9 analysis). (G) Receiver operating curve analysis for the percentage of agrin-positive (red), CD133-positive (blue), and combination of agrin-positive and CD133-positive (purple) EVs coupled to beads and CA19-9 (green) in the serum of patients with PDAC not submitted to surgery and treated with chemotherapy (n=17). In tables: a means under the non-parametric assumption and b means null hypothesis: true area=0.5. EVs, extracellular vesicles; PDAC, pancreatic ductal adenocarcinoma.