Blood-based gene tests show promise for pancreatic cancer screening

Researchers at Kanazawa University report the blood-based gene expression tests may enable early pancreatic cancer screening and improve long-term survival.

Pancreatic cancer is one of the most malignant cancers, with a five-year relative survival rate of only 8.5% in Japan (2009–2011, National Cancer Center data). Curative treatment is only possible when the disease is detected early and surgical resection can be performed. However, early-stage pancreatic cancer accounts for only 2–3% of all diagnosed cases due to the difficulty of early detection. This diagnostic challenge is a major factor contributing to the poor prognosis of pancreatic cancer. To improve outcomes, there is an urgent need for non-invasive diagnostic methods, particularly blood-based biomarkers, capable of efficiently detecting early-stage disease.

A research group led by Dr. Yamashita, Dean of the Graduate School of Advanced Preventive Medical Sciences and Professor of Gastroenterology at the Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, has previously developed a pancreatic cancer diagnostic test called "Panregza", which combines gene expression patterns from peripheral whole blood with the serum tumor marker CA19-9. While its effectiveness has been demonstrated primarily in advanced pancreatic cancer, its usefulness for detecting early-stage disease had not been clarified until now.

Yamashita and colleagues analyzed 10 patients with stage 0–Ⅰ pancreatic cancer (representing 4% of 253 cases) and compared them with 104 healthy individuals. The following diagnostic approaches were evaluated: 1) Peripheral whole blood gene expression patterns (mRNA), 2) Tumor marker CA19-9, 3) Combined test (Panregza).

Using a panel of 56 gene probes, the gene expression approach successfully detected 9 out of 10 cases (90%) of early-stage pancreatic cancer (Figure 1). In contrast, CA19-9 detected only 1 out of 10 cases (10%), showing a substantial difference in detection performance. The combined Panregza test demonstrated 60% sensitivity and 93.3% specificity. These findings indicate that gene expression analysis from peripheral whole blood is a highly effective method for detecting early-stage pancreatic cancer. At Innovative Research and Development Center for Pancreatic Cancer, Kanazawa University Hospital, five-year survival rates are 100% for Stage 0 and 74.4% for Stage Ⅰ pancreatic cancer (Figure 2), emphasizing the critical role of early diagnosis in improving prognosis.

Background

Gene expression test in peripheral whole blood in pancreatic cancer

Researchers at Kanazawa University have previously found that gene expression patterns in peripheral blood mononuclear cells (PBMCs) differ between patients with pancreatic cancer and healthy individuals. Based on this finding, they developed a diagnostic kit called Panregza using whole blood and CA19-9, which is currently marketed by Cubix Inc.

Most PBMCs are immune cells, and it has been assumed that pancreatic cancer cells induce changes in gene expression by influencing these immune cells. However, it has remained unclear whether such expression changes also occur in early-stage pancreatic cancer, where the tumor burden is minimal.

This study demonstrated that even in stage 0–Ⅰ pancreatic cancer with normal CA19-9 levels, abnormalities in whole blood gene expression can be detected. These findings suggest that this diagnostic test enables early detection of pancreatic cancer and is not dependent on tumor volume.

Innovative Research and Development Center for Pancreatic Cancer at Kanazawa University Hospital

In response to the rising incidence of pancreatic cancer in recent years, this center was established in April 2025 with the aim of developing innovative diagnostic and therapeutic approaches. The center is led by Professor Shintaro Yagi of the Department of Hepato-Biliary-Pancreatic Surgery and Transplantation. Specialists from the Departments of Gastroenterology, Hepato-Biliary-Pancreatic Surgery and Transplantation, Radiology, Medical Oncology, and Pathology collaborate closely to advance the diagnosis, treatment, and research of pancreatic cancer.