血清 microRNA 特征可用于非小细胞肺癌的早期诊断。

Serum microRNA Signature Is Capable of Early Diagnosis for Non-Small Cell Lung Cancer.

机构信息

Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Xian Jiaotong University, Xi'an, Shaanxi, China.

Affiliated Hospital of Guangdong Medical University, Zhanjiang, China.

出版信息

Int J Biol Sci. 2019 Jun 10;15(8):1712-1722. doi: 10.7150/ijbs.33986. eCollection 2019.

Abstract

Despite decades of efforts, non-small-cell lung cancer (NSCLC) remains the leading cause of cancer mortality globally primarily due to the challenge in early detection of the cancer. Being an important player in cancer development, the dysregulated miRNAs have been shown promising values as non-invasive diagnostic and prognostic biomarkers for NSCLC. The aim of our study is to access the efficacy and reliability of a potential circulating miRNA panel in early diagnosis of NSCLC. We first selected eight candidate miRNAs, miR-146b, miR-205, miR-29c, miR-31, miR-30b, miR-337, miR-411, and miR-708, which have been shown frequently aberrant in primary NSCLC patients based on our previous studies and other reports. The serum level of each of these miRNAs was evaluated by quantitative real-time PCR (qRT-PCR) in training and testing sets. We found that 5 out of 8 miRNAs (miR-146b, miR-205, miR-29c, miR-30b, and miR-337) were significantly up-regulated in NSCLCs patients compared to healthy or cancer-free controls in both training and testing sets. Based on the logistic regression model, a 4-miRNAs set (miR-146b, miR-205, miR-29c and miR-30b) was picked out of the 5 miRNAs owing to its excellent diagnostic power for NSCLC patients in the training set (AUC=0.99, accuracy=95.00%), the testing set (AUC=0.93, accuracy=89.69%), and the training-testing combined set ( AUC=0.96, accuracy=92.00%). When pathological subtypes of NSCLC are compared, this 4-miRNA panel carried a relatively higher prediction power and higher sensitivity for adenocarcinoma (AC) (AUC=0.98, sensitivity=99.10%) than for squamous cell carcinoma (SCC) (AUC=0.93, sensitivity=90.32%). Additionally, this panel demonstrated a comparable diagnostic capacity for stage I (AUC=0.96) and stage II-III (AUC=0.95) of NSCLC, suggesting its role in reflecting the tumor load. Importantly, the high levels of miR-146b and miR-29c in serum were significantly associated with poor 5-year overall survival (OS) (both p=0.04). Further survival analysis showed that high level of miR-146b in serum is specifically correlated with poor survival rate in SCC patients (p=0.0035) but not in AC patients (p=0.83), consistent with our previous finding that the high tissue expression of miR-146b in lung cancer specimen is indicative of a poor prognosis for SCC patients. Altogether, our study demonstrated that the 4-miRNA panel is a novel, sensitive and non-invasive serum marker for the early diagnosis of NSCLC.

摘要

尽管经过几十年的努力,非小细胞肺癌(NSCLC)仍然是全球癌症死亡的主要原因,主要是由于癌症早期检测的挑战。miRNA 作为癌症发展的重要参与者,已被证明作为 NSCLC 的非侵入性诊断和预后生物标志物具有很大的价值。我们的研究旨在评估一种潜在的循环 miRNA 谱在 NSCLC 早期诊断中的功效和可靠性。我们首先选择了八个候选 miRNA,miR-146b、miR-205、miR-29c、miR-31、miR-30b、miR-337、miR-411 和 miR-708,这些 miRNA 在前瞻性研究和其他报告中经常在原发性 NSCLC 患者中出现异常。通过定量实时 PCR(qRT-PCR)在训练集和测试集中评估了这些 miRNA 中的每一种的血清水平。我们发现,与健康或无癌症对照组相比,8 个 miRNA 中有 5 个(miR-146b、miR-205、miR-29c、miR-30b 和 miR-337)在训练集和测试集中均在 NSCLC 患者中显着上调。基于逻辑回归模型,由于其在训练集中对 NSCLC 患者具有出色的诊断能力(AUC=0.99,准确性=95.00%),因此从这 5 个 miRNA 中挑选出了 4 个 miRNA 集(miR-146b、miR-205、miR-29c 和 miR-30b),在测试集中(AUC=0.93,准确性=89.69%)和训练-测试联合组(AUC=0.96,准确性=92.00%)。当比较 NSCLC 的病理亚型时,与 SCC 相比,该 4- miRNA 组对腺癌(AC)具有相对较高的预测能力和更高的敏感性(AUC=0.98,敏感性=99.10%)。该面板对 NSCLC 的 I 期(AUC=0.96)和 II-III 期(AUC=0.95)具有可比的诊断能力,表明其在反映肿瘤负荷方面的作用。重要的是,血清中 miR-146b 和 miR-29c 的高水平与 5 年总生存率(OS)显著相关(均 p=0.04)。进一步的生存分析表明,血清中 miR-146b 的高水平与 SCC 患者的生存率降低密切相关(p=0.0035),但与 AC 患者无关(p=0.83),与我们之前的发现一致,即肺癌标本中 miR-146b 的高组织表达表明 SCC 患者预后不良。总的来说,我们的研究表明,4-miRNA 谱是一种新型、敏感和非侵入性的 NSCLC 早期诊断血清标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6ba/6643220/28843cf03c4e/ijbsv15p1712g001.jpg

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