Similar results were obtained, that both p-ERK1/2 and p-MEK1 levels were significantly increased in sera from PaCa patients compared with that of HVs for validation set 1 (p-ERK1/2; P<0.00001, p-MEK1; P<0.00001: Mann–Whitney U-test; Figure 3A). This evidence concerns the gene MAPK3 and permanent neonatal diabetes mellitus-pancreatic and cerebellar agenesis syndrome.