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Background: Pancreatic cancer PC is one of the most deadly cancers. Existing tumor markers, such as carbohydrate antigen 19-9 and carcinoembryonic antigen, have relatively poor diagnostic sensitivity and specificity. Intraductal papillary mucinous neoplasm IPMN is related to pancreatic carcinogenesis and is treated as a precursor of PC. We analyzed the miRNA expression profiles of exosome-rich fractionated blood of IPMN, PC and control patients to identify biomarkers that ould facilitate early diagnosis of PC. Methods: RNA from the exosome-rich fraction as extracted from eight PCs, eight IPMNs and eight non-pancreatic disease controls NC . Extracted RNA as subjected to miRNA profiling using an Agilent miRNA microarray and Illumina next-generation sequencer NGS . Results: IPMN and PC patients ere discriminated from controls ith 91.6 percent and 95.8 percent accuracy, respectively, using the expression profiles of 11 and 19 miRNAs determined by microarray and NGS analyses, respectively. Using NGS, 168 novel miRNA candidates ere identified. Six candidate miRNAs ere detected in patients ith PC but not in those ith IPMN or NC. One candidate miRNA as detected among all patients ith PC but not those ith IPMN. Conclusions: The results of our analysis of miRNAs associated ith pancreatic disease ere highly reproducible. We could identify pancreatic disease ith a high probability using the expression profiles of existing miRNAs and novel candidate miRNAs. Therefore, miRNA expression profiles sho promise for the early diagnosis of PC at the precancerous stage. UMIN No.: 000017958 ,J Clin Oncol 34, 2016 suppl; abstr e15671 ,Publication Only Gastrointestinal Noncolorectal Cancer