CTSE and pancreatic adenocarcinoma: In PAAD, the most genetic alterations were mainly in MOCOS and CTSE. MOCOS was altered in 7/184 (3.8%) cases, including 1.63% (3 cases) of amplification and 2.17% (4 cases) of deep deletion, CTSE was altered in 5/184 (2.72%) cases, including 1.09% (2 cases) of mutation and 1.63% (3 cases) of amplification.