Exosomal glypican-1 is elevated in pancreatic cancer precursors and can signal genetic predisposition in the absence of endoscopic ultrasound abnormalities

Figure 4 Glypican-1-positive circulating exosomes are higher in individuals with personal history of cancer within the hereditary risk group, and among patients harboring pancreatic cystic lesions when worrisome features/high-risk stigmata are present. A: Scatter dot plot representing the percentage of beads bound to glypican-1 (GPC1)-positive circulating exosomes (GPC1⁺ crExos) in subjects in the hereditary risk (HR) group, without (n = 14) and with (n = 6) a personal history of cancer (HxCancer) [Mann-Whitney U Test, P = non-significant (NS)]; B: Scatter dot plot representing the serum carbohydrate antigen 19-9 (CA 19-9) concentration (U/mL) as determined by enzyme-linked immunoassay (ELISA) in subjects in the HR group, without (n = 14) and with (n = 6) HxCancer (Mann-Whitney U Test, P = 0.21); C: Scatter dot plot representing the percentage of GPC1⁺ crExos coupled to beads in subjects harboring pancreatic cystic lesions, without (n = 24) and with (n = 20) worrisome features (WF) or high-risk stigmata (HRS) (Mann-Whitney U Test, ^fP = 0.011); D: Scatter dot plot representing the serum CA 19-9 concentration (U/mL) as determined by ELISA in subjects harboring pancreatic cystic lesions, without (n = 24) and with (n = 20) WF/HRS (Mann-Whitney U Test, P = NS); E: Receiver operating characteristic curve of the cohort of pancreatic cystic lesions without (n = 24) or with (n = 20) WF/HRS, regarding the GPC1⁺ crExos levels (% beads with GPC1⁺ crExos). ¹Under nonparametric assumption; ²Null hypothesis: True area = 0.5. Data are shown as the median ± interquartile range. NS: Non-significant; GPC1: Glypican-1; crExos: Circulating exosomes; WF: Worrisome features; HRS: High-risk stigmata.