• Stefania Bunduc, Noémi Gede, Szilárd Váncsa, Veronika Lillik, Szabolcs Kiss, Márk Félix Juhász, Bálint Erőss, Zsolt Szakács, Cristian Gheorghe, Alexandra Mikó, and Péter Hegyi.
• Institute for Translational Medicine, Medical School, University of Pécs, 7624 Pécs, Szigeti ú;t 12, Hungary; Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; Fundeni Clinical Institute, 022328 Bucharest, Romania; Center for Translational Medicine, Semmelweis University, 1085 Budapest, Üllői út 26, Hungary; Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, 1085 Budapest, Baross út 22-24, Hungary.
• Transl Res. 2022 Jun 1; 244: 126136126-136.

AbstractExtensive research is focused on the role of liquid biopsy in pancreatic cancer since reliable diagnostic and follow-up biomarkers represent an unmet need for this highly lethal malignancy. We performed a systematic review and meta-analysis on the prognostic value of exosomal biomarkers in pancreatic ductal adenocarcinoma (PDAC). MEDLINE, Embase, Scopus, Web of Science, and CENTRAL were systematically searched on the 18th of January, 2021 for studies reporting on the differences in overall (OS) and progression-free survival (PFS) in PDAC patients with positive vs negative exosomal biomarkers isolated from blood. The random-effects model estimated pooled multivariate-adjusted (AHR) and univariate hazard ratios (UHRs) with 95% confidence intervals (CIs). Eleven studies comprising 634 patients were eligible for meta-analysis. Detection of positive exosomal biomarkers indicated increased risk of mortality (UHR = 2.81, CI:1.31-6,00, I2 = 88.7%, P < 0.001), and progression (UHR = 3.33, CI: 2.33-4.77, I2 = 0, P = 0.879) across various disease stages. Positive exosomal biomarkers identified preoperatively revealed a higher risk of mortality in resectable stages (UHR = 5.55, CI: 3.24-9.49, I2 = 0, P = 0.898). The risk of mortality in unresectable stages was not significantly increased with positive exosomal biomarkers (UHR = 2.51, CI: 0.55-11.43, I2 = 90.3%, P < 0.001). Detectable exosomal micro ribonucleic acids were associated with a decreased OS (UHR = 4.08, CI: 2.16-7.69, I2 = 46.9%, P = 0.152) across various stages. Our results reflect the potential of exosomal biomarkers for prognosis evaluation in PDAC. The associated heterogeneity reflects the variability of study methods and need for their uniformization before transition to clinical use.Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.

16 keywords...

hide…