ITGB4 and pachyonychia congenita: Serum exosomal miR-1246, miR-4644, miR-3976 and miR-4306 were significantly upregulated in 83% of PC serum-exosomes, but rarely in control groups. Additionally, It was found that a combination of five proteins (CD44v6, Tspan8, EpCAM, MET and CD104) and four miRNAs (miR-1246, miR-4644, miR-3976 and miR-4306) in circulating tumor exosomes could recognize PC from healthy control, chronic pancreatitis and benign pancreatic disease with a sensitivity and specificity of 100% and 80% respectively.