Pancreatic cancer -initiating cell (PaCIC) markers, such as CD44v6, Tspan8, EpCAM, MET and CD104, combined with miRNA serum-exosome biomarkers including miR-1246, miR-4644, miR-3976 and miR-4306, improved sensitivity significantly with a specificity of 80 % for pancreatic cancer compared to all others groups [18]. This evidence concerns the gene EPCAM and familial pancreatic carcinoma.