Advances in the application of extracellular vesicles in precise diagnosis of pancreatic cancer.

Pancreatic cancer is a highly malignant tumor with poor prognosis, emphasizing the need for accurate early diagnosis. EVs, as mediators of intercellular communication, carry DNA, RNA, and proteins that show differential but not tumor-specific expression patterns in pancreatic cancer. Studies have shown that combining RNA markers in EVs (such as miRNA, circRNA, and lncRNA) with serum CA 19-9 testing can significantly enhance diagnostic accuracy for pancreatic cancer. EV-associated proteins have exhibited favorable diagnostic performance in early-stage pancreatic cancer in preliminary studies, though their clinical applicability remains to be further validated. Furthermore, mutations in KRAS, TP53, and SMAD4 genes within EVs offer a promising avenue for non-invasive liquid biopsy. However, challenges such as standardization, low sensitivity, and specificity still hinder the clinical application of EVs. Future research should focus on strategies including multi-omics integration, AI-assisted analysis, multi-marker combined detection, and large-scale clinical validation to further improve the diagnostic capability for pancreatic cancer. Overcoming these obstacles may position EVs as a vital tool in the diagnosis of pancreatic cancer.