Liquid biopsy approach to pancreatic cancer

Table 1 Recent exosomal cargos described in diagnosis/prognosis of pancreatic cancer

Proteins	Source	Outcome	Utility	Ref.
CLDN4, EPCAM, CD151, LGALS3BP, HIST2H2BE, and HIST2H2BF	Blood	Higher KRAS mutation in exosomes	Protein panel PC exosome-enriched samples	Castillo et al[114]
TAAs	Plasma	Higher levels of circulating Ig-bound exosomes in PC patients than in healthy individuals	Circulating AAbs against TAAs to discern between PC, CHP and healthy individuals	Capello et al[104]
CEACAM 1/5 and tenascin C	Pancreatic duct fluid	Upregulation in PC	Distinguish patients with PC/IPMN or CHP	Zheng et al[105]
RNA
exo-miR155	Plasma Tissue	GEM-resistant cells secreted higher levels of exo-miR-155 miR-155 expression level induced exosome secretion	Predict resistance to Gemcitabine. Novel therapeutic target	Mikamori et al[106]
exo-miR-10b, miR-21, miR-30c, miR-181a and miR-let7a	Serum	Upregulation in exo-miR-10b, miR-21, miR-30c, miR-181a; Repression in miR-let7a	Distinguish patients with CP/CHP or other pancreatic disease; PC resection monitoring	Lai et al[107]
exo-miR-451a	Serum	Upregulation in stage II PC with recurrence after surgery	Biomarkerofrecurrence	Takahasi et al[108]
exo-miR-191, miR-21 and miR-451	Serum	Dysregulated in IPMN and PC patients	Diagnosticbiomarkers	Goto et al[115]
exo-miR-21 and exo-miR-155	Pancreatic juice	Upregulation in PC patients compared with CHP	Diagnostic of early-stage PC	Nakamura et al[116]
miR-4525, miR-451a, and miR-21	PVB	Upregulation of the panel	Identify patients at high risk for recurrence and poor survival after PC resection	Kawamura et al[109]
mRNA
MMP8, TBX3, PDX1, CTSL, SIGLEC15, IL32, SIGLEC11, DCN, HOXA5, KLRB1	Serum	MMP8, TBX3, PDX1, CTSL, SIGLEC15 overexpression in PC/IPMN vs healthy; IL32, SIGLEC11, DCN repression in PC vs IPMN and healthy; HOXA5, KLRB1 repression in PC/IPMN vs healthy	Identify different subtypes	Kumar et al[110]
CCDC88A, ARF6, VAV3, and WASF2	Serum	Upregulation between PC and control patients	PC risk and PC diagnosis	Kitagawa et al[111]
circRNA
circPDE8A; circIARS	Tumor tissues Plasma	Upregulation in PC	Predictlivermetastasis, vascular invasion, and tumor-node-metastasis (TNM) stage and por postoperativesurvival time	Li et al[112]
circPC	Tumor tissues Serum	Upregulation in PC	Diagnostic biomarker	Seimiya et al[113]

PC: Pancreatic cancer; TAAs: Tumor-associated antigens; AAbs: Autoantibodies; CHP: Chronic pancreatitis; IPMN: Intraductal papillary mucinous neoplasm; GEM: Gemcitabine; PVB: Portal vein blood.