Objective:

To evaluate the diagnostic performance of a blood-based biomarker panel for early detection of pancreatic ductal adenocarcinoma (PDAC).

Key Findings:

• ANPEP and PIGR were present at higher levels in early-stage PDAC patients compared to healthy individuals.
• Individually, ANPEP and PIGR showed moderate diagnostic ability with AUC values from 0.78 to 0.86.
• Combining ANPEP and PIGR with CA19-9 and THBS2 improved accuracy, achieving AUC values up to 0.97.
• The four-marker panel detected 87.5% of early-stage PDAC cases at 95% specificity.

Interpretation:

Combining multiple biomarkers enhances diagnostic accuracy for early-stage PDAC, potentially improving early detection and clinical decision-making.

Limitations:

• Retrospective study design.
• Need for further testing in prospective and prediagnostic populations.

Conclusion:

Expanding plasma biomarker panels may significantly improve early detection of pancreatic cancer.