Explainable AI Framework for Urinary Biomarker-Based Early Detection of Pancreatic Cancer: Clinical Implications of Autoencoder-Optimized XGBoost

Objective: This study aims to construct a high-precision decision support model by integrating explainable artificial intelligence (XAI) techniques utilizing urinary and plasma biomarkers. Methods: We used an open-access dataset published by Debernardi et al. (2020) containing the biomarkers Lymphatic Vessel Endothelial Hyaluronan Receptor 1 (LYVE1), Regenerating Family Member 1 Beta (REG1B), Trefoil Factor 1 (TFF1), and plasma CA19-9. The preprocessing phase involved missing value imputation, Z-score normalization, and feature engineering. An autoencoder (AE)-based unsupervised learning framework was employed for dimensionality reduction. Classification was performed using an XGBoost algorithm optimized via the Optuna framework. Class imbalance was addressed through the Synthetic Minority Over-sampling Technique (SMOTE). Model interpretability was ensured using SHapley Additive Explanations (SHAP). Results: The proposed Autoencoder–XGBoost model optimized with Optuna outperformed conventional methods, achieving an accuracy of 95.8%, 95% precision, 93% recall, 93% F1-score, and an AUC of 0.984. SHAP analysis identified plasma CA19-9, LYVE1, creatinine, and age as the most influential predictors contributing to model decisions. Conclusion: The developed XAI framework offers high diagnostic accuracy and transparent decision logic for the early detection of PDAC. By leveraging the clinical potential of urinary biomarkers, the model demonstrates strong applicability for integration into screening and risk stratification modules of clinical decision support systems.