{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:49:31Z","timestamp":1785408571683,"version":"3.56.0"},"reference-count":94,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005888","name":"Medical University of Lodz","doi-asserted-by":"publisher","award":["503\/1-002-01\/503-11-001"],"award-info":[{"award-number":["503\/1-002-01\/503-11-001"]}],"id":[{"id":"10.13039\/501100005888","id-type":"DOI","asserted-by":"publisher"}]},{"award":["503\/1-002-01\/503-11-001"],"award-info":[{"award-number":["503\/1-002-01\/503-11-001"]}],"id":[{"id":"https:\/\/ror.org\/02t4ekc95","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>MicroRNAs are small noncoding RNA molecules that regulate gene expression at the post-transcriptional level and play a key role in cancer development, progression, and response to therapy. Their relative stability in biological fluids and disease-associated expression patterns have positioned microRNAs as promising candidates for non-invasive cancer biomarkers. Liquid biopsy enables the detection of circulating and fluid-derived microRNAs in a range of biological materials, including blood, urine, saliva, stool, pancreatic cyst fluid, and bile, offering a minimally invasive complement to tissue-based diagnostics. This approach is particularly relevant in pancreatic ductal adenocarcinoma, a malignancy with high mortality driven largely by late diagnosis, aggressive disease course, and limited opportunities for curative treatment. This review summarizes current evidence on microRNA-based liquid biopsy approaches in this cancer, with a focus on diagnostic, prognostic, and predictive relevance. Serum and plasma remain the most extensively studied sources, while urine-based microRNA profiling has shown relatively consistent diagnostic performance across available studies, including in early-stage disease. Pancreatic cyst fluid and bile offer more lesion-proximal molecular information but are limited to selected clinical scenarios because of invasive sampling requirements. In contrast, salivary microRNA signatures show greater variability and lower reproducibility across studies. Overall, liquid biopsy based on microRNA analysis shows promise as a complementary tool for pancreatic ductal adenocarcinoma detection and risk stratification. However, substantial methodological heterogeneity and limited cross-study reproducibility currently limit clinical translation, underscoring the need for standardized workflows and prospective validation of clinically relevant microRNA panels.<\/jats:p>","DOI":"10.3390\/ijms27125468","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T10:19:53Z","timestamp":1781691593000},"page":"5468","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Liquid Biopsy-Derived microRNAs in Pancreatic Ductal Adenocarcinoma: Matrix-Specific Evidence and Translational Challenges"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-0459-0642","authenticated-orcid":false,"given":"Maria","family":"Wo\u0142yniak","sequence":"first","affiliation":[{"name":"Department of Digestive Tract Diseases, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0496-293X","authenticated-orcid":false,"given":"Edward","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Digestive Tract Diseases, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mateusz","family":"Polak","sequence":"additional","affiliation":[{"name":"Department of Digestive Tract Diseases, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanis\u0142aw","family":"Trojanowski","sequence":"additional","affiliation":[{"name":"Department of Digestive Tract Diseases, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1825-1807","authenticated-orcid":false,"given":"Ewa","family":"Ma\u0142ecka-Wojciesko","sequence":"additional","affiliation":[{"name":"Department of Digestive Tract Diseases, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"104","DOI":"10.31662\/jmaj.2023-0009","article-title":"Roles of MicroRNAs in Disease Biology","volume":"6","author":"Suzuki","year":"2023","journal-title":"JMA J."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Komatsu, S., Kitai, H., and Suzuki, H.I. (2023). Network Regulation of MicroRNA Biogenesis and Target Interaction. Cells, 12.","DOI":"10.3390\/cells12020306"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Chakrabortty, A., Patton, D.J., Smith, B.F., and Agarwal, P. (2023). MiRNAs: Potential as Biomarkers and Therapeutic Targets for Cancer. Genes, 14.","DOI":"10.20944\/preprints202306.0045.v1"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"15004","DOI":"10.1038\/sigtrans.2015.4","article-title":"The Role of MicroRNAs in Human Cancer","volume":"1","author":"Peng","year":"2016","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Kapszewicz, M., and Ma\u0142ecka-Wojciesko, E. (2021). Simple Serum Pancreatic Ductal Adenocarcinoma (PDAC) Protein Biomarkers\u2014Is There Anything in Sight?. J. Clin. Med., 10.","DOI":"10.3390\/jcm10225463"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1186\/s12943-023-01870-3","article-title":"Liquid Biopsy Techniques and Pancreatic Cancer: Diagnosis, Monitoring, and Evaluation","volume":"22","author":"Wang","year":"2023","journal-title":"Mol. Cancer"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/j.molmed.2010.07.001","article-title":"Circulating Tumour Cells in Cancer Patients: Challenges and Perspectives","volume":"16","author":"Pantel","year":"2010","journal-title":"Trends Mol. Med."},{"key":"ref_8","first-page":"229","article-title":"Global Cancer Statistics 2022: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"ref_9","first-page":"17","article-title":"Cancer Statistics, 2023","volume":"73","author":"Siegel","year":"2023","journal-title":"CA Cancer J. Clin."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1056\/NEJMra1404198","article-title":"Pancreatic Adenocarcinoma","volume":"371","author":"Ryan","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"S58","DOI":"10.4103\/eus.eus_60_17","article-title":"Pancreatic Ductal Adenocarcinoma Epidemiology and Risk Assessment: Could We Prevent? Possibility for an Early Diagnosis","volume":"6","author":"Bekkali","year":"2017","journal-title":"Endosc. Ultrasound"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1093\/carcin\/bgy067","article-title":"Common Genetic Variants Associated with Pancreatic Adenocarcinoma May Also Modify Risk of Pancreatic Neuroendocrine Neoplasms","volume":"39","author":"Obazee","year":"2018","journal-title":"Carcinogenesis"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2065","DOI":"10.1002\/ijc.33004","article-title":"Genome-Wide Association Study Identifies an Early Onset Pancreatic Cancer Risk Locus","volume":"147","author":"Campa","year":"2020","journal-title":"Int. J. Cancer"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1136\/gutjnl-2019-319352","article-title":"Management of Patients with Increased Risk for Familial Pancreatic Cancer: Updated Recommendations from the International Cancer of the Pancreas Screening (CAPS) Consortium","volume":"69","author":"Goggins","year":"2020","journal-title":"Gut"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Wang, K., Yuan, Y., Cho, J.H., McClarty, S., Baxter, D., and Galas, D.J. (2012). Comparing the MicroRNA Spectrum between Serum and Plasma. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0041561"},{"key":"ref_16","first-page":"8040419","article-title":"MicroRNA-125a-3p, -4530, and -92a as a Potential Circulating MicroRNA Panel for Noninvasive Pancreatic Cancer Diagnosis","volume":"2022","author":"Shams","year":"2022","journal-title":"Dis. Markers"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Makler, A., and Asghar, W. (2023). Exosomal MiRNA Biomarker Panel for Pancreatic Ductal Adenocarcinoma Detection in Patient Plasma: A Pilot Study. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24065081"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s00432-016-2248-7","article-title":"Plasma MiR-22-3p, MiR-642b-3p and MiR-885-5p as Diagnostic Biomarkers for Pancreatic Cancer","volume":"143","author":"Hussein","year":"2017","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1716","DOI":"10.1159\/000447872","article-title":"Identification of Circulating MiR-25 as a Potential Biomarker for Pancreatic Cancer Diagnosis","volume":"39","author":"Deng","year":"2016","journal-title":"Cell. Physiol. Biochem."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2810","DOI":"10.1002\/cam4.2145","article-title":"Identification of a Six-MiRNA Panel in Serum Benefiting Pancreatic Cancer Diagnosis","volume":"8","author":"Zou","year":"2019","journal-title":"Cancer Med."},{"key":"ref_21","first-page":"3455","article-title":"Noninvasive Urinary MiRNA Biomarkers for Early Detection of Pancreatic Adenocarcinoma","volume":"5","author":"Debernardi","year":"2015","journal-title":"Am. J. Cancer Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"S99","DOI":"10.4103\/eus.eus_72_17","article-title":"Pancreatic Solid Incidentalomas","volume":"6","author":"Santo","year":"2017","journal-title":"Endosc. Ultrasound"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"21264","DOI":"10.1038\/s41598-020-65695-6","article-title":"MIR1246 in Body Fluids as a Biomarker for Pancreatic Cancer","volume":"10","author":"Ishige","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_24","first-page":"2677","article-title":"MiR-3940-5p\/MiR-8069 Ratio in Urine Exosomes Is a Novel Diagnostic Biomarker for Pancreatic Ductal Adenocarcinoma","volume":"19","author":"Yoshizawa","year":"2020","journal-title":"Oncol. Lett."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Imamura, T., Komatsu, S., Nishibeppu, K., Kiuchi, J., Ohashi, T., Konishi, H., Shiozaki, A., Yamamoto, Y., Moriumura, R., and Ikoma, H. (2024). Urinary MicroRNA-210-3p as a Novel and Non-Invasive Biomarker for the Detection of Pancreatic Cancer, Including Intraductal Papillary Mucinous Carcinoma. BMC Cancer, 24.","DOI":"10.1186\/s12885-024-12676-x"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1097\/MPA.0000000000000383","article-title":"MiRNA-21 and MiRNA-34a Are Potential Minimally Invasive Biomarkers for the Diagnosis of Pancreatic Ductal Adenocarcinoma","volume":"45","author":"Alemar","year":"2016","journal-title":"Pancreas"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Humeau, M., Vignolle-Vidoni, A., Sicard, F., Martins, F., Bournet, B., Buscail, L., Torrisani, J., and Cordelier, P. (2015). Salivary MicroRNA in Pancreatic Cancer Patients. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0130996"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2375","DOI":"10.3892\/or.2016.5021","article-title":"MIR1246 and MIR-4644 in Salivary Exosome as Potential Biomarkers for Pancreatobiliary Tract Cancer","volume":"36","author":"Machida","year":"2016","journal-title":"Oncol. Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1158\/1940-6207.CAPR-14-0192","article-title":"Salivary MicroRNAs Show Potential as a Noninvasive Biomarker for Detecting Resectable Pancreatic Cancer","volume":"8","author":"Xie","year":"2015","journal-title":"Cancer Prev. Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.1038\/ajg.2013.103","article-title":"Pancreatic Cyst Prevalence and the Risk of Mucin-Producing Adenocarcinoma in US Adults","volume":"108","author":"Gardner","year":"2013","journal-title":"Am. J. Gastroenterol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1053\/j.gastro.2015.01.014","article-title":"American Gastroenterological Association Technical Review on the Diagnosis and Management of Asymptomatic Neoplastic Pancreatic Cysts","volume":"148","author":"Scheiman","year":"2015","journal-title":"Gastroenterology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1882","DOI":"10.1001\/jama.2016.4690","article-title":"Pancreatic Cyst Disease: A Review","volume":"315","author":"Stark","year":"2016","journal-title":"JAMA"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1159\/000101873","article-title":"Precursor Lesions of Pancreatic Cancer: Molecular Pathology and Clinical Implications","volume":"7","author":"Singh","year":"2007","journal-title":"Pancreatology"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.cgh.2007.05.010","article-title":"The Pancreatic Cyst Incidentaloma: Management Consensus?","volume":"5","author":"DiMagno","year":"2007","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"19820","DOI":"10.1038\/s41598-023-47129-1","article-title":"MiR-200b Categorizes Patients into Pancreas Cystic Lesion Subgroups with Different Malignant Potential","volume":"13","author":"Benke","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Shirakami, Y., Iwashita, T., Uemura, S., Imai, H., Murase, K., and Shimizu, M. (2021). Micro-RNA Analysis of Pancreatic Cyst Fluid for Diagnosing Malignant Transformation of Intraductal Papillary Mucinous Neoplasm by Comparing Intraductal Papillary Mucinous Adenoma and Carcinoma. J. Clin. Med., 10.","DOI":"10.3390\/jcm10112249"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e350","DOI":"10.1038\/mtna.2016.61","article-title":"A MicroRNA Panel in Pancreatic Cyst Fluid for the Risk Stratification of Pancreatic Cysts in a Prospective Cohort","volume":"5","author":"Utomo","year":"2016","journal-title":"Mol. Ther. Nucleic Acids"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.canlet.2014.09.029","article-title":"Next Generation Sequencing of Pancreatic Cyst Fluid MicroRNAs from Low Grade-Benign and High Grade-Invasive Lesions","volume":"356","author":"Wang","year":"2015","journal-title":"Cancer Lett."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1038\/ajg.2013.167","article-title":"Endoscopically Acquired Pancreatic Cyst Fluid MicroRNA 21 and 221 Are Associated with Invasive Cancer","volume":"108","author":"Farrell","year":"2013","journal-title":"Am. J. Gastroenterol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1159\/000329183","article-title":"Elevated MicroRNA MiR-21 Levels in Pancreatic Cyst Fluid Are Predictive of Mucinous Precursor Lesions of Ductal Adenocarcinoma","volume":"11","author":"Ryu","year":"2011","journal-title":"Pancreatology"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1093\/ecco-jcc\/jjz120","article-title":"Faecal Micro-RNAs in Inflammatory Bowel Diseases","volume":"14","author":"Verdier","year":"2020","journal-title":"J. Crohns Colitis"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2994","DOI":"10.1158\/1078-0432.CCR-13-1750","article-title":"Identification of MicroRNA-135b in Stool as a Potential Noninvasive Biomarker for Colorectal Cancer and Adenoma","volume":"20","author":"Wu","year":"2014","journal-title":"Clin. Cancer Res."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Masi, L., Capobianco, I., Magr\u00ec, C., Marafini, I., Petito, V., and Scaldaferri, F. (2022). MicroRNAs as Innovative Biomarkers for Inflammatory Bowel Disease and Prediction of Colorectal Cancer. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23147991"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Rashid, H., Hossain, B., Siddiqua, T., Kabir, M., Noor, Z., Ahmed, M., and Haque, R. (2020). Fecal MicroRNAs as Potential Biomarkers for Screening and Diagnosis of Intestinal Diseases. Front. Mol. Biosci., 7.","DOI":"10.3389\/fmolb.2020.00181"},{"key":"ref_45","first-page":"215","article-title":"Exosome Can Prevent RNase from Degrading MicroRNA in Feces","volume":"2","author":"Koga","year":"2011","journal-title":"J. Gastrointest. Oncol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"otaa003","DOI":"10.1093\/crocol\/otaa003","article-title":"Fecal MicroRNAs Show Promise as Noninvasive Crohn\u2019s Disease Biomarkers","volume":"2","author":"Wohnhaas","year":"2020","journal-title":"Crohns Colitis 360"},{"key":"ref_47","first-page":"201","article-title":"Differential Signature of Fecal MicroRNAs in Patients with Pancreatic Cancer","volume":"6","author":"Ren","year":"2012","journal-title":"Mol. Med. Rep."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Link, A., Becker, V., Goel, A., Wex, T., and Malfertheiner, P. (2012). Feasibility of Fecal MicroRNAs as Novel Biomarkers for Pancreatic Cancer. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0042933"},{"key":"ref_49","first-page":"663","article-title":"MicroRNAs in Stool Samples as Potential Screening Biomarkers for Pancreatic Ductal Adenocarcinoma Cancer","volume":"4","author":"Yang","year":"2014","journal-title":"Am. J. Cancer Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1942","DOI":"10.1038\/ajg.2014.331","article-title":"A Pilot Study to Develop a Diagnostic Test for Pancreatic Ductal Adenocarcinoma Based on Differential Expression of Select MiRNA in Plasma and Bile","volume":"109","author":"Cote","year":"2014","journal-title":"Am. J. Gastroenterol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1016\/j.pan.2022.04.010","article-title":"Extracellular Vesicle-Derived MicroRNAs in Pancreatic Juice as Biomarkers for Detection of Pancreatic Ductal Adenocarcinoma","volume":"22","author":"Nesteruk","year":"2022","journal-title":"Pancreatology"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"6518","DOI":"10.1097\/JS9.0000000000001888","article-title":"MicroRNAs as Bile-Based Biomarkers in Pancreaticobiliary Cancers (MIRABILE): A Cohort Study","volume":"110","author":"Liu","year":"2024","journal-title":"Int. J. Surg."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"2616","DOI":"10.1002\/ijc.29324","article-title":"Combined Evaluation of a Panel of Protein and MiRNA Serum-Exosome Biomarkers for Pancreatic Cancer Diagnosis Increases Sensitivity and Specificity","volume":"136","author":"Madhavan","year":"2015","journal-title":"Int. J. Cancer"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"77028","DOI":"10.18632\/oncotarget.20332","article-title":"Plasma Exosome MiR-196a and MiR-1246 Are Potential Indicators of Localized Pancreatic Cancer","volume":"8","author":"Xu","year":"2017","journal-title":"Oncotarget"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Hajatdoost, L., Sedaghat, K., Walker, E.J., Thomas, J., and Kosari, S. (2018). Chemotherapy in Pancreatic Cancer: A Systematic Review. Medicina, 54.","DOI":"10.3390\/medicina54030048"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"42339","DOI":"10.1038\/srep42339","article-title":"MicroRNA-155 Controls Exosome Synthesis and Promotes Gemcitabine Resistance in Pancreatic Ductal Adenocarcinoma","volume":"7","author":"Mikamori","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Richards, K.E., Xiao, W., and Hill, R. (2022). Cancer-Associated Fibroblasts Confer Gemcitabine Resistance to Pancreatic Cancer Cells through PTEN-Targeting MiRNAs in Exosomes. Cancers, 14.","DOI":"10.3390\/cancers14112812"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1002\/mc.23668","article-title":"Cancer-Associated Fibroblasts Promote Stemness Maintenance and Gemcitabine Resistance via HIF-1\u03b1\/MiR-21 Axis under Hypoxic Conditions in Pancreatic Cancer","volume":"63","author":"Deng","year":"2024","journal-title":"Mol. Carcinog."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.3724\/abbs.2022194","article-title":"DSCR9\/MiR-21-5p Axis Inhibits Pancreatic Cancer Proliferation and Resistance to Gemcitabine via BTG2 Signaling","volume":"54","author":"Huang","year":"2022","journal-title":"Acta Biochim. Biophys. Sin."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e12488","DOI":"10.1002\/jev2.12488","article-title":"Extracellular Vesicles MiR-31-5p Promote Pancreatic Cancer Chemoresistance via Regulating LATS2-Hippo Pathway and Promoting SPARC Secretion from Pancreatic Stellate Cells","volume":"13","author":"Qin","year":"2024","journal-title":"J. Extracell. Vesicles"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1038\/s41419-023-06244-7","article-title":"FTO-Mediated LINC01134 Stabilization to Promote Chemoresistance through MiR-140-3p\/WNT5A\/WNT Pathway in PDAC","volume":"14","author":"Lu","year":"2023","journal-title":"Cell Death Dis."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.canlet.2012.10.008","article-title":"MiRNA Profiling in Pancreatic Cancer and Restoration of Chemosensitivity","volume":"334","author":"Singh","year":"2013","journal-title":"Cancer Lett."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1007\/s10565-022-09736-y","article-title":"MiR-222-3p-Containing Macrophage-Derived Extracellular Vesicles Confer Gemcitabine Resistance via TSC1-Mediated MTOR\/AKT\/PI3K Pathway in Pancreatic Cancer","volume":"39","author":"Guo","year":"2023","journal-title":"Cell Biol. Toxicol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.cellsig.2013.11.003","article-title":"MiR-365 Induces Gemcitabine Resistance in Pancreatic Cancer Cells by Targeting the Adaptor Protein SHC1 and Pro-Apoptotic Regulator BAX","volume":"26","author":"Hamada","year":"2014","journal-title":"Cell. Signal."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/j.bbrc.2019.01.030","article-title":"Leptin-Elicited MiRNA-342-3p Potentiates Gemcitabine Resistance in Pancreatic Ductal Adenocarcinoma","volume":"509","author":"Ma","year":"2019","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1093\/abbs\/gmv129","article-title":"MiR-125a Regulates Chemo-Sensitivity to Gemcitabine in Human Pancreatic Cancer Cells through Targeting A20","volume":"48","author":"Yao","year":"2015","journal-title":"Acta Biochim. Biophys. Sin."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1572","DOI":"10.1038\/bjc.2014.454","article-title":"MicroRNA-1246 Expression Associated with CCNG2-Mediated Chemoresistance and Stemness in Pancreatic Cancer","volume":"111","author":"Hasegawa","year":"2014","journal-title":"Br. J. Cancer"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.3892\/ijo.2013.2037","article-title":"MicroRNA-29a Induces Resistance to Gemcitabine through the Wnt\/\u03b2-Catenin Signaling Pathway in Pancreatic Cancer Cells","volume":"43","author":"Nagano","year":"2013","journal-title":"Int. J. Oncol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/j.pan.2013.06.007","article-title":"Involvement of MicroRNA-181b in the Gemcitabine Resistance of Pancreatic Cancer Cells","volume":"13","author":"Takiuchi","year":"2013","journal-title":"Pancreatology"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"111543","DOI":"10.1016\/j.yexcr.2019.111543","article-title":"Exosomal MiRNA-106b from Cancer-Associated Fibroblast Promotes Gemcitabine Resistance in Pancreatic Cancer","volume":"383","author":"Fang","year":"2019","journal-title":"Exp. Cell Res."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1186\/s13148-015-0166-1","article-title":"MicroRNA-100 and MicroRNA-21 as Markers of Survival and Chemotherapy Response in Pancreatic Ductal Adenocarcinoma UICC Stage II","volume":"7","author":"Dhayat","year":"2015","journal-title":"Clin. Epigenet."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1186\/s13046-022-02343-z","article-title":"Circular RNA Circ-MTHFD1L Induces HR Repair to Promote Gemcitabine Resistance via the MiR-615-3p\/RPN6 Axis in Pancreatic Ductal Adenocarcinoma","volume":"41","author":"Chen","year":"2022","journal-title":"J. Exp. Clin. Cancer Res."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"101079","DOI":"10.1016\/j.drup.2024.101079","article-title":"TRIM29 Facilitates Gemcitabine Resistance via MEK\/ERK Pathway and Is Modulated by CircRPS29\/MiR-770-5p Axis in PDAC","volume":"74","author":"Huang","year":"2024","journal-title":"Drug Resist. Updat."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1186\/s12943-022-01587-9","article-title":"Hsa-MiR-3178\/RhoB\/PI3K\/Akt, a Novel Signaling Pathway, Regulates ABC Transporters to Reverse Gemcitabine Resistance in Pancreatic Cancer","volume":"21","author":"Gu","year":"2022","journal-title":"Mol. Cancer"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"e33775","DOI":"10.1097\/MD.0000000000033775","article-title":"Hsa_circ_0007401 Regulates Gemcitabine Resistance of Pancreatic Cancer through the Hsa-MiR-6509-3p\/Fli1 Axis","volume":"102","author":"Han","year":"2023","journal-title":"Medicine"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"6704","DOI":"10.1158\/0008-5472.CAN-09-1298","article-title":"Up-Regulation of MiR-200 and Let-7 by Natural Agents Leads to the Reversal of Epithelial-to-Mesenchymal Transition in Gemcitabine-Resistant Pancreatic Cancer Cells","volume":"69","author":"Li","year":"2009","journal-title":"Cancer Res."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Panebianco, C., Trivieri, N., Villani, A., Terracciano, F., Latiano, T.P., Potenza, A., Perri, F., Binda, E., and Pazienza, V. (2021). Improving Gemcitabine Sensitivity in Pancreatic Cancer Cells by Restoring MiRNA-217 Levels. Biomolecules, 11.","DOI":"10.3390\/biom11050639"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1016\/j.bbrc.2016.12.074","article-title":"MicroRNA-101 Silences DNA-PKcs and Sensitizes Pancreatic Cancer Cells to Gemcitabine","volume":"483","author":"Hu","year":"2017","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1007\/s10585-023-10256-0","article-title":"MiRNAs in Pancreatic Cancer Progression and Metastasis","volume":"41","author":"Mok","year":"2024","journal-title":"Clin. Exp. Metastasis"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1111\/cas.13159","article-title":"MicroRNA-181b-5p, ETS1, and the c-Met Pathway Exacerbate the Prognosis of Pancreatic Ductal Adenocarcinoma after Radiation Therapy","volume":"108","author":"Tomihara","year":"2017","journal-title":"Cancer Sci."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.1097\/MPA.0000000000000640","article-title":"MiR-216b Targets FGFR1 and Confers Sensitivity to Radiotherapy in Pancreatic Ductal Adenocarcinoma Patients without EGFR or KRAS Mutation","volume":"45","author":"Egeli","year":"2016","journal-title":"Pancreas"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1186\/s12943-020-01178-6","article-title":"Dying Tumor Cell-Derived Exosomal MiR-194-5p Potentiates Survival and Repopulation of Tumor Repopulating Cells upon Radiotherapy in Pancreatic Cancer","volume":"19","author":"Jiang","year":"2020","journal-title":"Mol. Cancer"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"e31346","DOI":"10.1016\/j.heliyon.2024.e31346","article-title":"Pancreatic Cancer Cells Hijack Tumor Suppressive MicroRNA-26a to Promote Radioresistance and Potentiate Tumor Repopulation","volume":"10","author":"Jiang","year":"2024","journal-title":"Heliyon"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"216873","DOI":"10.1016\/j.canlet.2024.216873","article-title":"RAS-RAF-MiR-296-3p Signaling Axis Increases Rad18 Expression to Augment Radioresistance in Pancreatic and Thyroid Cancers","volume":"591","author":"Wolfe","year":"2024","journal-title":"Cancer Lett."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1007\/s00432-024-05954-5","article-title":"Trametinib in Combination with Hydroxychloroquine or Palbociclib in Advanced Metastatic Pancreatic Cancer: Data from a Retrospective, Multicentric Cohort (AIO AIO-TF\/PAK-0123)","volume":"150","author":"Witte","year":"2024","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"Gu, W., Shen, H., Xie, L., Zhang, X., and Yang, J. (2022). The Role of Feedback Loops in Targeted Therapy for Pancreatic Cancer. Front. Oncol., 12.","DOI":"10.3389\/fonc.2022.800140"},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Amanam, I., and Chung, V. (2018). Targeted Therapies for Pancreatic Cancer. Cancers, 10.","DOI":"10.3390\/cancers10020036"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.1093\/jpp\/rgad055","article-title":"Homoharringtonine Sensitizes Pancreatic Cancer to Erlotinib by Direct Targeting and MiRNA-130b-3p-Mediated EphB4-JAK2-STAT3 Axis","volume":"75","author":"Sarwar","year":"2023","journal-title":"J. Pharm. Pharmacol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1111\/jphp.12941","article-title":"Targeting EphA2 with MiR-124 Mediates Erlotinib Resistance in K-RAS Mutated Pancreatic Cancer","volume":"71","author":"Du","year":"2019","journal-title":"J. Pharm. Pharmacol."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1159\/000447302","article-title":"The Clinical Significance of MIR-34a in Pancreatic Ductal Carcinoma and Associated Molecular and Cellular Mechanisms","volume":"84","author":"Long","year":"2016","journal-title":"Pathobiology"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/j.tranon.2014.05.007","article-title":"MicroRNA-196a and -196b as Potential Biomarkers for the Early Detection of Familial Pancreatic Cancer","volume":"7","author":"Slater","year":"2014","journal-title":"Transl. Oncol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"6495867","DOI":"10.1155\/2017\/6495867","article-title":"Evaluation of Plasma MicroRNAs as Diagnostic and Prognostic Biomarkers in Pancreatic Adenocarcinoma: MiR-196a and MiR-210 Could Be Negative and Positive Prognostic Markers, Respectively","volume":"2017","author":"Yu","year":"2017","journal-title":"BioMed Res. Int."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"154244","DOI":"10.1016\/j.prp.2022.154244","article-title":"A Review on the Role of MiR-210 in Human Disorders","volume":"241","author":"Khalilian","year":"2023","journal-title":"Pathol. Res. Pract."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1093\/carcin\/bgad056","article-title":"A Scan of All Coding Region Variants of the Human Genome Identifies 13q12.2-rs9579139 and 15q24.1-rs2277598 as Novel Risk Loci for Pancreatic Ductal Adenocarcinoma","volume":"44","author":"Giaccherini","year":"2023","journal-title":"Carcinogenesis"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/12\/5468\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T10:21:27Z","timestamp":1781691687000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/12\/5468"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,17]]},"references-count":94,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["ijms27125468"],"URL":"https:\/\/doi.org\/10.3390\/ijms27125468","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,17]]}}}