Liang Chen, Yitong Yuchi, Qian Zhu
Intraductal Papillary Mucinous Neoplasm (IPMN) is a major precancerous lesion of pancreatic ductal adenocarcinoma. Accurate risk stratification of IPMN is key to preventing and controlling pancreatic cancer. At present, clinicians mainly grade IPMN following the Kyoto consensus guidelines, together with imaging examinations and traditional serum biomarkers like CA19-9 and CEA. This review unveils the latest research progress of non-invasive blood biomarkers for the grading of IPMN, including the diagnostic performance, molecular mechanisms, and current clinical translation of several types of markers. ApoAII has already been applied in clinical practice, and miRNA combinations, circulating cell-free DNA (cfDNA) methylation panels, and other markers show excellent value in IPMN stratification. However, the field still faces bottlenecks in clinical translation. In the future, researchers should focus on exploring specific targets for IPMN malignant transformation, unifying detection standards, and building multi-dimensional combined evaluation models. These efforts will help promote the application of non-invasive blood biomarkers in accurate IPMN grading and support the early screening and treatment of pancreatic cancer. It not only enables doctors to comprehensively understand the research status of existing non-invasive blood markers for IPMN, but also provides guidance for exploring promising non-invasive biomarkers in future studies.