Pancreatic ductal adenocarcinoma (PDAC) is a lethal malignancy characterised by late diagnosis and poor prognosis. Despite advancements, current diagnostic and prognostic strategies remain limited. Liquid biopsy techniques, including circulating tumour DNA (ctDNA), circulating tumour cells (CTCs), circulating tumour exosomes, and proteomics, offer potential solutions to improve PDAC diagnosis, prognostication, and management. A systematic search of Ovid MEDLINE identified studies published between 2019 and 2024, focusing on liquid biopsy biomarkers for PDAC. A total of 49 articles were included. ctDNA research shows some promise in diagnosing and prognosticating PDAC, especially through detecting mutantKRASin minimal residual disease assays. CTC analyses had low sensitivity for early-stage PDAC and inconsistent prognostic results across subpopulations. Exosomal studies revealed diverse biomarkers with some diagnostic and prognostic potential. Proteomics, although relatively novel, has demonstrated superior accuracy in PDAC diagnosis, including early detection, and notable prognostic capacity. Proteomics combined with CA19-9 analysis has shown the most promising results to date. An update on multi-cancer early detection testing, given its significance for population screening, is also briefly discussed. Liquid biopsy techniques offer promising avenues for improving PDAC diagnosis, prognostication, and management. In particular, proteomics shows considerable potential, yet further research is needed to validate existing findings and comprehensively explore the proteome using an unbiased approach.
胰腺导管腺癌（PDAC）是一种致死性恶性肿瘤，其特点是诊断晚、预后差。尽管诊疗技术有所进步，但目前的诊断和预后评估策略仍存在局限。液体活检技术，包括循环肿瘤DNA（ctDNA）、循环肿瘤细胞（CTCs）、循环肿瘤外泌体以及蛋白质组学，为改善PDAC的诊断、预后评估和治疗管理提供了潜在解决方案。通过对Ovid MEDLINE数据库进行系统性检索，筛选出2019年至2024年间发表的关于PDAC液体活检生物标志物的研究，共纳入49篇文献。ctDNA研究在PDAC诊断和预后评估方面显示出一定潜力，尤其是在微小残留病灶检测中通过突变KRAS基因进行监测。CTC分析对早期PDAC的敏感性较低，且在不同亚群中的预后评估结果不一致。外泌体研究揭示了多种具有诊断和预后潜力的生物标志物。蛋白质组学虽相对较新，但在PDAC诊断（包括早期检测）中表现出较高的准确性，并具有显著的预后评估能力。蛋白质组学与CA19-9联合分析迄今显示出最具前景的结果。鉴于多癌种早期检测对人群筛查的重要意义，本文还简要讨论了该技术的最新进展。液体活检技术为改善PDAC的诊断、预后评估和治疗管理提供了有前景的途径。特别是蛋白质组学展现出巨大潜力，但仍需进一步研究以验证现有发现，并采用无偏倚方法全面探索蛋白质组。
Evolution of Liquid Biopsies for Detecting Pancreatic Cancer
肿瘤(癌症)患者之家