Pancreatic ductal adenocarcinoma represents a disease with increasing incidence. Its prognosis is the worst among all malignancies despite the aggressive combined multimodal treatment across all stages. In metastatic disease, median survival is approximatelly one year. The mainstay of treatment is chemotherapy (neo/adjuvant, palliative) and in selected subgroups of patients even radiotherapy. Nevertheless, nowadays there are very few prognostic and/or predictive biomarkers available that can be used to identify and better stratify patients based on risk to tailored treatment. Potentially, promising areas of research are circulating tumor cells and circulating tumor DNA, which can be easily obtained from peripheral blood – so called liquid biopsy. They may serve as a tool to assess response to applied treatment, and to detect the emergence of treatment-resistant clones or early disease relapse. Moreover, their study may allow identification of potentially tumor-specific alterations, which may serve as target structures for targeted (tailored) therapy. Alternatively, different prognostic indexes/scores calculated by analysis of selected parameters of blood and/or biochemistry can be used to better stratify patients based on risk and better predict prognosis. The aim of this mini-review is to provide a basic overview of the current state of the art in this area and its potential significance for clinical practice.

中文翻译：

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胰腺导管腺癌的循环肿瘤细胞、循环肿瘤 DNA 和其他基于血液的预后评分 - 小型综述

胰腺导管腺癌是一种发病率越来越高的疾病。尽管在所有阶段进行了积极的联合多模式治疗，但它的预后是所有恶性肿瘤中最差的。在转移性疾病中，中位生存期约为一年。主要的治疗方法是化疗（新/辅助、姑息治疗），在选定的患者亚组中甚至是放疗。然而，现在很少有预后和/或预测性生物标志物可用于根据定制治疗的风险来识别和更好地对患者进行分层。潜在的、有前景的研究领域是循环肿瘤细胞和循环肿瘤 DNA，它们可以很容易地从外周血中获得——即所谓的液体活检。它们可以作为评估对应用治疗的反应的工具，并检测抗药性克隆的出现或早期疾病复发。此外，他们的研究可能允许识别潜在的肿瘤特异性改变，这些改变可以作为靶向（定制）治疗的靶标结构。或者，通过分析选定的血液和/或生物化学参数计算出的不同预后指数/分数可用于根据风险更好地对患者进行分层并更好地预测预后。这篇小型综述的目的是对该领域的当前技术水平及其对临床实践的潜在意义提供一个基本概述。通过分析选定的血液和/或生物化学参数计算出的不同预后指标/评分可用于根据风险更好地对患者进行分层并更好地预测预后。这篇小型综述的目的是对该领域的当前技术水平及其对临床实践的潜在意义提供一个基本概述。通过分析选定的血液和/或生物化学参数计算出的不同预后指标/评分可用于根据风险更好地对患者进行分层并更好地预测预后。这篇小型综述的目的是对该领域的当前技术水平及其对临床实践的潜在意义提供一个基本概述。