Logozzi Mariantonia, Mizzoni Davide, Di Raimo Rossella, Giuliani Alessandro, Maggi Martina, Sciarra Alessandro, Fais Stefano
Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy.
Environment and Health Department, Istituto Superiore di Sanità, Rome, Italy.
Front Oncol. 2021 Oct 20;11:727317. doi: 10.3389/fonc.2021.727317. eCollection 2021.
There is a urgent need for valuable strategy in early and less invasive diagnosis for cancer. Preliminary data have shown that the plasmatic levels of exosomes increase in cancer condition. This study investigates the relevance of plasmatic levels and size distribution of exosomes in 42 individuals with no signs of urological disease (CTR) as compared to 65 prostate cancer patients (PCa). It was used Nanoparticle Tracking Analysis (NTA), a highly reliable and sensitive method for exosomes characterization and quantification. The relation structure among the NTA-derived parameters was assessed by means of Principal Component Analysis, which allowed detecting the global discriminant power of NTA test in terms of Receiver Operating Characteristic (ROC) curve and the selection of cut-off thresholds. The results showed that PCa had significantly higher plasmatic levels of exosomes and that the exosomes were smaller in size as compared to the CTR; the values reached 89% sensitivity and 71% specificity, in distinguishing PCa from CTR. These results propose a new exosome-based non-invasive clinical approach for the clinical follow-up of prostate cancer undergoing surgical treatment; in addition this method may be developed as a new screening test for prostate cancer's early diagnosis. While this clinical study was performed in prostate cancer, it may represent a proof of concept extendable to virtually all cancers, as it is suggested by both pre-clinical evidence and clinical data obtained with different technical approaches.
癌症的早期和微创诊断急需有价值的策略。初步数据表明，癌症状态下外泌体的血浆水平会升高。本研究调查了42名无泌尿系统疾病迹象的个体（对照组）与65名前列腺癌患者（PCa）相比，血浆中外泌体水平与大小分布的相关性。使用了纳米颗粒跟踪分析（NTA），这是一种用于外泌体表征和定量的高度可靠且灵敏的方法。通过主成分分析评估了NTA衍生参数之间的关系结构；主成分分析能够根据受试者工作特征（ROC）曲线检测NTA测试的整体判别能力，并选择临界阈值。结果表明，与对照组相比，PCa患者血浆中外泌体水平显著更高，且外泌体尺寸更小；在区分PCa和对照组时，这些值的灵敏度达到89%，特异性达到71%。这些结果提出了一种基于外泌体的新型非侵入性临床方法，用于接受手术治疗的前列腺癌患者的临床随访；此外，这种方法可发展成为一种用于前列腺癌早期诊断的新型筛查测试。虽然这项临床研究是在前列腺癌中进行的，但正如不同技术方法获得的临床前证据和临床数据所表明的那样，它可能代表了一个可扩展到几乎所有癌症的概念验证。
