Potential epigenetic biomarkers for the diagnosis and prognosis of pancreatic ductal adenocarcinomas

With an estimated 37,000 deaths per year, pancreatic cancer is the fourth leading cause of cancer deaths in the USA. A total of 95% of pancreatic cancers are exocrine neoplasms, known as pancreatic ductal adenocarcinomas (PDACs). The difficulty of early diagnosis and the high prevalence of metastasis associated with PDAC contribute to its dismal prognosis. The past decade has witnessed intensive study and impressive progress in searching for more sensitive, specific and cost-effective biomarkers. This review focuses on the epigenetic biomarkers potentially useful for the management of PDAC. The authors begin with an overview on the available biomarkers, and subsequently discuss the recent development in epigenetic biomarkers, including DNA methylation, miRNA and histone modifications in diversified specimens of cell lines, xenograft, cancer tissues, pancreatic juice and patient blood. These findings raise the possibility for clinical application of epigenetic biomarkers towards screening, early diagnosis, prognosis, chemosensitivity prediction and recurrence surveillance of PDAC patients.