Serum PCSK9 is a novel serological biomarker for the diagnosis and prognosis of pancreatic cancer

Background Although CA19-9 is an essential blood biomarker of pancreatic cancer (PC), its sensitivity and specificity are limited for early detection. Methods We analyzed the serum proprotein convertase subtilisin/kexin type 9 (sPCSK9) in PC patients, benign disease groups (BDG), and healthy controls (HC) by ELISA. Results Consistently, sPCSK9 was considerably lower in PC patients than in HC (Z = −2.546, P < 0.05), and sPCSK9 in PC patients was statistically significantly higher than in BDG (Z = −5.457, P < 0.001). sPCSK9 was linked to the invasion of lymph nodes (χ 2 = 6.846, P < 0.01). According to ROC curves, combining sPCSK9 with CA19-9 could potentially enhance the diagnostic capability of CA19-9 in early-stage PC patients. Furthermore, the low sPCSK9 group ( n = 41) exhibited statistically significantly prolonged overall survival compared to the high sPCSK9 group ( n = 15), with median survival times of 27 months (95% CI [17.59–36.41]) and 11 months (95% CI [7.21–14.79]), respectively ( P = 0.022). Conclusion The diagnostic performance of CA19-9 for early-stage PC patients could be improved by combining sPCSK9 with CA19-9. Moreover, the higher sPCSK9 group has a significantly shorter overall survival rate.