Liquid biopsy in pancreatic ductal adenocarcinoma and precancerous lesions

Abstract

Pancreatic ductal adenocarcinoma ranks seventh among all cancer-related causes of death and has an overall 5-year survival rate of no more than 15% across all stages. This high mortality rate is largely attributed to delayed diagnosis: due to late clinical manifestation and early metastasis, only about 5% of pancreatic ductal adenocarcinoma cases are detected at stage I. Another important issue is the risk of overtreatment in patients with benign or non-neoplastic pancreatic conditions that mimic pancreatic ductal adenocarcinoma, often resulting in unnecessary and invasive surgeries. A diagnostic approach capable of detecting pancreatic ductal adenocarcinoma with high sensitivity at early stages and distinguishing it from benign pancreatic diseases could improve survival rates and reduce the number of unwarranted high-risk procedures. One of the most promising technologies for early and noninvasive cancer detection is liquid biopsy. This term refers to a set of analytical methods designed to identify tumor-specific genetic, epigenetic, and antigenic alterations by analyzing tumor-derived materials in biological fluids such as plasma, bile, or urine. Liquid biopsy may be used not only for early detection of pancreatic ductal adenocarcinoma and its precursors in high-risk individuals but also for differential diagnosis. This review summarizes current research evaluating the diagnostic potential of liquid biopsy through the detection of extracellular tumor DNA and RNA, as well as circulating tumor cells in blood, pancreatic juice, and bile in patients with pancreatic neoplasms.

Keywords

circulating tumor DNA / microRNA / circulating tumor cells / liquid biopsy / pancreatic ductal adenocarcinoma / review

Funding

МГУ имени М.В. ЛомоносоваState assignment of Lomonosov Moscow State University

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