// Zhe Cao 1, * , Chang Liu 2, * , Jianwei Xu 3, * , Lei You 1 , Chunyou Wang 4 , Wenhui Lou 5 , Bei Sun 6 , Yi Miao 7 , Xubao Liu 8 , Xiaowo Wang 2 , Taiping Zhang 1 , Yupei Zhao 1 1 Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China 2 MOE Key Laboratory of Bioinformatics, Bioinformatics Division and Center for Synthetic and Systems Biology, TNLIST/Department of Automation, Tsinghua University, Beijing, 100084, China 3 Department of General Surgery, Qilu Hospital, Shandong University, Jinan, 250012, China 4 Department of General Surgery, Pancreatic Disease Institute, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430022, China 5 Department of Pancreatic Surgery, Zhong Shan Hospital, Fudan University, Shanghai, 200032, China 6 Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Harbin Medical University, Harbin, 150001, China 7 Department of General Surgery, The First Affiliated Hospital, Nanjing Medical University, Nanjing, 210029, China 8 Department of Hepatopancreatobiliary Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China * These authors contributed equally to this work and are co-first authors Correspondence to: Xiaowo Wang, email: xwwang@tsinghua.edu.cn Taiping Zhang, email: tpingzhang@yahoo.com Yupei Zhao, email: zhao8028@263.net Keywords: pancreatic cancer, microRNA panels, multicenter study, diagnosis Received: February 15, 2016 Accepted: May 04, 2016 Published: May 19, 2016 ABSTRACT Biomarkers for the early diagnosis of pancreatic cancer (PC) are urgent needed. Plasma microRNAs (miRNAs) might be used as biomarkers for the diagnosis of cancer. We analyzed 361 plasma samples from 6 surgical centers in China and performed machine learning approach. We gain insight of the association between the aberrant plasma miRNA expression and pancreatic disease. 671 microRNAs were screened in the discovery phase and 33 microRNAs in the training phase and 13 microRNAs in the validation phase. After the discovery phase and training phase, 2 diagnostic panels were constructed comprising 3 microRNAs in panel I (miR-486-5p, miR-126-3p, miR-106b-3p) and 6 microRNAs in panel II (miR-486-5p, miR-126-3p, miR-106b-3p, miR-938, miR-26b-3p, miR-1285). Panel I and panel II had high accuracy for distinguishing pancreatic cancer from chronic pancreatitis (CP) with area under the curve (AUC) values of 0.891 (Standard Error (SE): 0.097) and 0.889 (SE: 0.097) respectively, in the validation phase. Additionally, we demonstrated that the diagnostic value of the panels in discriminating PC from CP were comparable to that of carbohydrate antigen 19–9 (CA 19–9) 0.775 (SE: 0.053) ( P = 0.1 for both). This study identified 2 diagnostic panels based on microRNA expression in plasma with the potential to distinguish PC from CP. These patterns might be developed as biomarkers for pancreatic cancer.