piRNAs and PIWI-like proteins in cancer and their future as biomarkers and therapy targets in pancreatic cancer: a systematic review

Abstract

Introduction: This systematic review explores the roles of PIWI-interacting RNAs (piRNAs) and PIWI-like proteins in pancreatic cancer, assessing their potential as diagnostic and therapeutic biomarkers. Recent studies suggest that piRNAs and PIWI proteins play roles in gene regulation associated with cancer progression, positioning them as promising targets in oncology. Methods: The review adhered to PRISMA guidelines, focusing on the potential of piRNAs and PIWI-like proteins as biomarkers for diagnosis, prognosis, or therapeutic prediction in pancreatic cancer. Studies in PubMed, EMBASE, and ScienceDirect were included, focusing on expression data, diagnosis, prognosis, or treatment of pancreatic tumors. Only studies published in English or Spanish from the last five years were considered. Risk of bias was assessed using SYRCLE’s tool, a modified CONSORT checklist, and AMSTAR2. Results: Five key studies were selected. Findings indicate that piR-162725 enhances diagnostic accuracy for early-stage pancreatic cancer in combination with CA19-9, while piR-017061 inhibits pancreatic cancer cell growth through EFNA5 mRNA degradation. PIWIL1 promotes metastasis via a piRNA-independent pathway, and piR-hsa-30937 in small extracellular vesicles creates an immunosuppressive environment in pancreatic neuroendocrine tumors. Conclusions: piRNAs and PIWI-like proteins demonstrate potential as biomarkers and therapeutic targets in pancreatic cancer. Future studies are required to validate these findings in larger cohorts and explore piRNA-based therapies. An in-depth understanding of piRNAs' mechanistic roles could improve early detection and therapeutic outcomes in pancreatic cancer.