Circulating Cell-Free DNA as a potential Diagnostic Tool in Pancreatic Cancer: A Comparative Analysis

Introduction: Liquid biopsies enable non-invasive tumor material sampling in patients with pancreatic adenocarcinoma (PDAC). Genetic information, especially alterations in circulating free DNA (cfDNA) levels, might help to predict poorer tumor differentiation, disease progression and might be used as treatment efficacy evaluator. However, the data on this topic is insufficient. Methods: Newly diagnosed, PDAC patients without prior systemic treatment and chronic pancreatitis patients treated at the tertiary university hospital and healthy controls were included in this prospective study. Blood samples were collected pre-treatment, and cfDNA was extracted and measured using necessary equipment according to manufacturer’s protocols. Results: 57 patients (47 PDAC and 10 chronic pancreatitis) and 8 healthy controls were included. cfDNA levels were significantly higher in cancer patients compared to chronic pancreatitis (p = 0,032) and healthy controls (p < 0.001). The determined cfDNA cut-off value for distinguishing PDAC from chronic pancreatitis was 23.65 ng/ml and for distinguishing PDAC from healthy controls - 22.9 ng/ml. However, no distinctions in cfDNA levels were noted concerning tumor characteristics or survival rates. Conclusion: Liquid biopsies and alterations in cfDNA levels could aid in distinguishing PDAC from benign inflammatory diseases or healthy patients. Nonetheless, further studies are necessary for more comprehensive validation.