Biomarkers for Early Detection of Pancreatic Cancer

Pancreatic cancer is one of the most difficult malignant tumors to be diagnosed and treated, with insidious onset, rapid progression and poor prognosis. Presently, surgery is still the preferred method for the treatment of pancreatic cancer. However, due to lack of early symptoms, approximately 70% of patients are diagnosed with local spread or distant metastasis, making it impossible to undergo surgical treatment. Development of effective approaches for better administration of the disease will be unmet and effective way for reducing the mortality and the morbidity. Unfortunately, detection of pancreatic cancer, especially at early stage, is challenged by the lack of highly sensitive and specific biomarkers. Imaging methods (CT, MRI, EUS, etc.) often fail to detect early lesions and is easily influenced by operator. Routine clinical markers such as CA19-9, CA125, CA242 and CEA were limited with unsatisfactory sensitivity or specificity. In recent years, extensive studies on biomarkers mainly focused on genetics, transcriptomics, and proteomics. Especially, non-protein coding RNA (ncRNA) consisting of microRNA (miRNA), long non-coding RNA (lncRNA) and circular RNA (circRNA) have proposed many new ideas about early detection of pancreatic cancer. However, the majority of them remain in the laboratory research stage. Few of them, to our knowledge, have gone into clinical practice. A mature study on biomarker may integrate data from genomics, transcriptomics, proteomics, or metabolomics, and combine with individual characteristics of patients (such as body mass index, history of diabetes, smoking, drinking and other risk factors) through largescale, prospective and validation studies.