Elevating pancreatic cystic lesion stratification: Current and future pancreatic cancer biomarker(s)

Biochim Biophys Acta Rev Cancer. 2020 Jan;1873(1):188318. doi: 10.1016/j.bbcan.2019.188318. Epub 2019 Oct 30.


Pancreatic ductal adenocarcinoma (PDAC) is an incredibly deadly disease with a 5-year survival rate of 9%. The presence of pancreatic cystic lesions (PCLs) confers an increased likelihood of future pancreatic cancer in patients placing them in a high-risk category. Discerning concurrent malignancy and risk of future PCL progression to cancer must be carefully and accurately determined to improve survival outcomes and avoid unnecessary morbidity of pancreatic resection. Unfortunately, current image-based guidelines are inadequate to distinguish benign from malignant lesions. There continues to be a need for accurate molecular and imaging biomarker(s) capable of identifying malignant PCLs and predicting the malignant potential of PCLs to enable risk stratification and effective intervention management. This review provides an update on the current status of biomarkers from pancreatic cystic fluid, pancreatic juice, and seromic molecular analyses and discusses the potential of radiomics for differentiating PCLs harboring cancer from those that do not.

Keywords: Biomarker; Early detection; IPMN; Pancreatic cancer; Pancreatic cystic lesions; Pancreatic ductal adenocarcinoma; Radiomics.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Biomarkers, Tumor / analysis
  • Carcinoma, Pancreatic Ductal / diagnosis*
  • Disease Progression
  • Early Detection of Cancer / methods*
  • Pancreas / pathology
  • Pancreatic Cyst / diagnosis*
  • Pancreatic Neoplasms / diagnosis*
  • Precancerous Conditions / diagnosis*
  • Risk Factors
  • Survival Analysis


  • Biomarkers, Tumor