이예린 (울산대학교)

이예린 (울산대학교)

 Pancreatic cancer is one of the most lethal malignancies, with most cases diagnosed at an advanced stage. Current diagnostic tools—such as imaging and biopsy—are often invasive and limited in detecting early-stage or minimal residual disease. Moreover, reliable biomarkers for recurrence monitoring remain insufficient in clinical practice. Circulating exosomes have emerged as a promising, minimally invasive biomarker source, as they encapsulate molecular signatures reflective of the tumor’s physiological and pathological state.

In this study, we aimed to identify serum-derived exosomal protein biomarkers associated with surgical intervention. Our goal was to support early diagnosis and recurrence risk stratification in pancreatic cancer. Exosomes were isolated from paired pre- and post-operative serum samples of pancreatic cancer patients and subjected to mass spectrometry-based proteomic profiling using label-free quantitation. A total of 91 differentially expressed proteins (DEPs) were identified. A classification model based on elastic net logistic regression using only two proteins achieved an AUC of 0.999. Additionally, a Random Forest classifier yielded 100% accuracy in cross-validation, confirming the clear distinction between surgical statuses. To assess recurrence risk, samples were analyzed separately. In the pre-operative group, 56 DEPs were identified between patients with and without recurrence. A model using two selected proteins achieved an AUC of 1.0. In the post-operative group, 21 DEPs were found, and a model using eight proteins reached an AUC of 0.99.

Although further validation in larger patient cohorts is required to overcome overfitting issue in model performance, this study highlights the clinical applicability of exosome-based proteomic profiling for monitoring surgical outcomes and predicting recurrence in pancreatic cancer.

This work was supported by the National Research Foundation of Korea(NRF) grant funded by the Korea government(MSIT) (No. RS-2025-02293074).