Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea.
Department of Biochemistry and Cell Biology, Cell and Matrix Research Institute, School of Medicine, Kyungpook National University, Daegu, South Korea.
Int J Cancer. 2019 Mar 15;144(6):1444-1452. doi: 10.1002/ijc.31931. Epub 2018 Dec 3.
Exosomal noncoding RNAs (ncRNAs) have unique expression profiles reflecting the characteristics of a tumor, and their role in tumor progression and metastasis is emerging. However, the significance of circulating exosomal ncRNAs in the prognosis of hepatocellular carcinoma (HCC) remains to be elucidated. We therefore determined the prognostic significance of circulating exosomal ncRNAs (miRNA-21 and lncRNA-ATB) for human HCC. This prospective study enrolled 79 HCC patients between October 2014 and September 2015. Exosomes were extracted from serum samples using the ExoQuick Exosome Precipitation Solution. To validate the isolation of the exosomes from serum, immunoblotting for exosome markers and characterization of nanoparticle using NanoSight were performed. NcRNAs were isolated from exosomes using the miRNeasy serum/plasma micro kit. Both circulating exosomal miRNA-21 and lncRNA-ATB were related to TNM stage and other prognostic factors, including the T stage and portal vein thrombosis. Multivariate analysis using the Cox regression test identified that both higher miRNA-21 and higher lncRNA-ATB were independent predictors of mortality and disease progression, along with larger tumor size and higher C-reactive protein (all p < 0.05). The overall survival and progression-free survival were significantly lower in patients with higher circulating levels of exosomal miRNA-21 (≥0.09) and lncRNA-ATB (≥0.0016) (log-rank test: p < 0.05). In conclusion, our study has provided strong evidence that circulating exosomal ncRNAs (miRNA-21 and lncRNA-ATB) are novel prognostic markers and therapeutic targets for HCC.
外泌体非编码 RNA(ncRNA)具有独特的表达谱,反映了肿瘤的特征,其在肿瘤进展和转移中的作用正在显现。然而,循环外泌体 ncRNA 在肝细胞癌(HCC)预后中的意义仍有待阐明。因此,我们确定了循环外泌体 ncRNA(miRNA-21 和 lncRNA-ATB)对人类 HCC 的预后意义。这项前瞻性研究纳入了 2014 年 10 月至 2015 年 9 月间的 79 例 HCC 患者。使用 ExoQuick Exosome Precipitation Solution 从血清样本中提取外泌体。为了验证从血清中分离出外泌体,进行了外泌体标志物的免疫印迹和纳米颗粒的 NanoSight 分析。使用 miRNeasy 血清/血浆 micro 试剂盒从外泌体中分离 ncRNA。循环外泌体 miRNA-21 和 lncRNA-ATB 均与 TNM 分期和其他预后因素相关,包括 T 分期和门静脉血栓形成。使用 Cox 回归检验进行多变量分析,确定较高的 miRNA-21 和较高的 lncRNA-ATB 是死亡率和疾病进展的独立预测因子,与较大的肿瘤大小和较高的 C 反应蛋白相关(均 p<0.05)。在循环外泌体 miRNA-21(≥0.09)和 lncRNA-ATB(≥0.0016)水平较高的患者中,总生存率和无进展生存率显著降低(log-rank 检验:p<0.05)。总之,我们的研究提供了强有力的证据,表明循环外泌体 ncRNA(miRNA-21 和 lncRNA-ATB)是 HCC 的新型预后标志物和治疗靶点。