Methylation-based Cell-free DNA Signature for Early Detection of Pancreatic Cancer

Pancreas. 2021 Oct 1;50(9):1267-1273. doi: 10.1097/MPA.0000000000001919.


Objectives: The potential of DNA methylation alterations in early pancreatic cancer (PC) detection among pancreatic tissue cell-free DNA seems promising. This study investigates the diagnostic capacity of the 4-gene methylation biomarker panel, which included ADAMTS1, BNC1, LRFN5, and PXDN genes, in a case-control study.

Methods: A genome-wide pharmacoepigenetic approach identified ADAMTS1, BNC1, LRFN5, and PXDN genes as putative targets. Tissue samples including stage I-IV PC (n = 44), pancreatic intraepithelial neoplasia (n = 15), intraductal papillary mucinous neoplasms (n = 24), and normal pancreas (n = 8), and cell-free DNA, which was acquired through methylation on beads technology from PC (n = 22) and control patients (n = 10), were included. The 2-∆ct was the outcome of interest and underwent receiver operating characteristic analysis to determine the diagnostic accuracy of the panel.

Results: Receiver operating characteristic analysis revealed an area under the curve of 0.93 among ADAMTS1, 0.76 among BNC1, 0.75 among PXDN, and 0.69 among LRFN5 gene. The combination gene methylation panel (ADAMTS1, BNC1, LRFN5, and PXDN) had an area under the curve of 0.94, with a sensitivity of 100% and specificity of 90%.

Conclusions: This methylation-based biomarker panel had promising accuracy for PC detection and warranted further validation in prospective PC surveillance trials.

MeSH terms

  • ADAMTS1 Protein / genetics
  • Aged
  • Biomarkers, Tumor / genetics*
  • Case-Control Studies
  • Cell Adhesion Molecules, Neuronal / genetics
  • Cell-Free Nucleic Acids / genetics*
  • DNA Methylation*
  • DNA-Binding Proteins / genetics
  • Early Detection of Cancer / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / genetics*
  • Peroxidases / genetics
  • ROC Curve
  • Transcription Factors / genetics


  • Biomarkers, Tumor
  • Cell Adhesion Molecules, Neuronal
  • Cell-Free Nucleic Acids
  • DNA-Binding Proteins
  • LRFN5 protein, human
  • Transcription Factors
  • BNC1 protein, human
  • PXDN protein, human
  • Peroxidases
  • ADAMTS1 Protein