Objective To analyze the changes of PRDM14 and IGFBP2 levels and their relationship with microvascular density in patients with pancreatic cancer before and after radical surgical resection. Methods Choose from January 2017 to December 2023 in Yanbian University Hospital during radical surgical resection surgery, 100 cases of pancreatic cancer patients as the research object, using flow cytometry instrument testing before and after operation in patients with lymphocytes,Enzyme-linked immunosorbent assay was used to detect the levels of S100A9, MMP-9, PRDM14 and IGFBP2 before and after surgery. Pearson correlation analysis was used to analyze the relationship between PRDM14, IGFBP2 and pancreatic cancer and microvessel density. ROC curve was applied to analyze the predictive value of PRDM14 and IGFBP2 for microvascular density in patients with pancreatic cancer. Results After radical surgical resection, the levels of S100A9, MMP-9, PRDM14 and IGFBP2 were decreased, while the levels of lymphocytes were significantly increased (P<0.05). The microvascular density was not related to sex, age and tumor location, but was related to tumor diameter, differentiation degree, TNM stage and lymph node metastasis. The microvascular density in the low-differentiated group was significantly higher than that in the medium-differentiated group and the highly differentiated group, and the microvascular density in the medium-differentiated group was higher than that in the highly differentiated group. The microvascular density of lymph node metastasis group was significantly higher than that of non-lymph node metastasis group (P<0.05). Spearman correlation analysis showed that the expression of PRDM14 and IGFBP2 were positively correlated with microvascular density in pancreatic cancer patients, with statistical differences (P<0.05). ROC analysis showed that combined diagnosis was higher than single diagnosis of PRDM14 and IGFBP2, with statistical difference (P<0.05). Conclusion The levels of PRDM14 and IGFBP2 showed a decreasing trend after radical surgical resection, and the levels of PRDM14 and IGFBP2 were positively correlated with microvascular density.