Badovinac David, Goričar Katja, Zavrtanik Hana, Petrič Miha, Lavrin Teja, Mavec Nina, Dolžan Vita, Tomažič Aleš, Lenassi Metka
Department of Abdominal Surgery, University Medical Centre Ljubljana, Zaloška 7, 1000 Ljubljana, Slovenia.
Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia.
J Pers Med. 2021 Jan 28;11(2):77. doi: 10.3390/jpm11020077.
Better preoperative characterization of patients with pancreatic ductal adenocarcinoma (PDAC) would aid in treatment optimization. Extracellular vesicles (EV) are promising, largely unexplored biomarkers in PDAC. This study aimed to evaluate if plasma EV characteristics are associated with PDAC clinical characteristics and overall survival (OS). The prospective cohort included 34 PDAC patients undergoing surgery with curative intent. Patient data and plasma samples were collected preoperatively, intraoperatively and one month postoperatively. Small plasma EV (sEV) concentration and size were determined by nanoparticle-tracking analysis. A Mann-Whitney test, Spearman's rho and Cox regression were used in statistical analysis. Preoperatively, patients with poorly differentiated tumors had significantly larger plasma sEVs when compared to patients with well/moderately differentiated tumors (mean diameter 176.9 vs. 149.2 nm, = 0.021), the sEV size even enabling discrimination of the two groups (AUC = 0.742, 95% CI = 0.560-0.923). Plasma sEV characteristics were also a predictor of OS in multivariable analysis. Patients with a more than 33.8% increase in sEV concentration after one month had 7.2 months shorter median OS ( = 0.002), while patients with a more than 28.0% decrease in sEV size had 9.2 months shorter median OS ( = 0.045). Plasma sEV concentration and size correlate with tumor differentiation and may predict OS in PDAC patients. In the future, plasma sEV characteristics could contribute to improved patient stratification for optimized treatment.
对胰腺导管腺癌（PDAC）患者进行更好的术前特征描述将有助于优化治疗。细胞外囊泡（EV）是PDAC中有前景但尚未充分探索的生物标志物。本研究旨在评估血浆EV特征是否与PDAC临床特征及总生存期（OS）相关。前瞻性队列研究纳入了34例接受根治性手术的PDAC患者。术前、术中及术后1个月收集患者数据和血浆样本。通过纳米颗粒追踪分析测定血浆小细胞外囊泡（sEV）浓度和大小。采用Mann-Whitney检验、Spearman相关系数和Cox回归进行统计分析。术前，与高/中分化肿瘤患者相比，低分化肿瘤患者的血浆sEV明显更大（平均直径176.9对149.2 nm，P = 0.021），sEV大小甚至能够区分这两组（AUC = 0.742，95%CI = 0.560 - 0.923）。在多变量分析中，血浆sEV特征也是OS的一个预测指标。术后1个月sEV浓度增加超过33.8%的患者，中位OS缩短7.2个月（P = 0.002），而sEV大小减少超过28.0%的患者，中位OS缩短9.2个月（P = 0.045）。血浆sEV浓度和大小与肿瘤分化相关，可能预测PDAC患者的OS。未来，血浆sEV特征可能有助于改善患者分层以优化治疗。
