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Pancreatic cancer is one of the most lethal solid tumor malignancies and it is projected to become a leading cause of cancer related deaths in coming years [1]. It is often diagnosed at an advanced stage owing to the lack of specific symptoms and rapid invasion [2]. Overall survival rate in pancreatic cancer patients is around 10% (American Cancer Society) and only 15% patients are found to have respectable diseases [3]. Thus, aggressiveness of diseases may limit the early diagnosis, contributes to the high mortality rate. Until now, we are also lacking efficient noninvasive biomarkers to detect the early stage and the progression of diseases. Best-known FDA approved biomarker for prognostic surveillance is carbohydrate antigen CA19-9 [4]. However, sensitivity and specificity of this marker to detect the severity in PDAC patients is very low. When released by PDAC patients, CA19-9 monitors the progression and relapse of diseases [5]. While CA199 levels are also high in chronic pancreatitis patients CP along with PDAC [6]. Due to these limitations, the clinical use of CA19-9 is discouraged in PDAC patients unless use in combination of other circulating biomarkers. The collection and analysis of pancreatic juice is invasive and cumbersome, however more informative [6]. The lack of robust noninvasive biomarker has encouraged scientists to explore more strategies.

Methylation Status of Tumor Suppressor Genes in Circulating DNA of PDAC Patients: Facts and Hopes