Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA.
Department of Pathology, University of Cambridge, Cambridge, UK.
Sci Rep. 2023 Jun 29;13(1):10558. doi: 10.1038/s41598-023-37271-1.
Circulating miR-371a-3p has excellent performance in the detection of viable (non-teratoma) germ cell tumor (GCT) pre-orchiectomy; however, its ability to detect occult disease is understudied. To refine the serum miR-371a-3p assay in the minimal residual disease setting we compared performance of raw (Cq) and normalized (∆Cq, RQ) values from prior assays, and validated interlaboratory concordance by aliquot swapping. Revised assay performance was determined in a cohort of 32 patients suspected of occult retroperitoneal disease. Assay superiority was determined by comparing resulting receiver-operator characteristic (ROC) curves using the Delong method. Pairwise t-tests were used to test for interlaboratory concordance. Performance was comparable when thresholding based on raw Cq vs. normalized values. Interlaboratory concordance of miR-371a-3p was high, but reference genes miR-30b-5p and cel-miR-39-3p were discordant. Introduction of an indeterminate range of Cq 28-35 with a repeat run for any indeterminate improved assay accuracy from 0.84 to 0.92 in a group of patients suspected of occult GCT. We recommend that serum miR-371a-3p test protocols are updated to (a) utilize threshold-based approaches using raw Cq values, (b) continue to include an endogenous (e.g., miR-30b-5p) and exogenous non-human spike-in (e.g., cel-miR-39-3p) microRNA for quality control, and (c) to re-run any sample with an indeterminate result.
循环 miR-371a-3p 在检测术前有活力(非畸胎瘤)生殖细胞肿瘤(GCT)方面表现出色;然而,其检测隐匿性疾病的能力尚未得到充分研究。为了在微小残留疾病环境下完善血清 miR-371a-3p 检测,我们比较了之前检测中原始(Cq)和标准化(∆Cq、RQ)值的表现,并通过分样交换验证了实验室间的一致性。在 32 名疑似腹膜后隐匿性疾病的患者队列中确定了修订后的检测性能。通过使用 Delong 方法比较所得的接受者操作特征(ROC)曲线来确定检测的优越性。使用配对 t 检验测试实验室间的一致性。基于原始 Cq 与标准化值进行阈值设置时,检测性能相当。miR-371a-3p 的实验室间一致性很高,但参考基因 miR-30b-5p 和 cel-miR-39-3p 不一致。对于任何不确定的 Cq 值在 28-35 范围内的引入,并为任何不确定的情况重复运行,可以将一组疑似隐匿性 GCT 患者的检测准确性从 0.84 提高到 0.92。我们建议更新血清 miR-371a-3p 检测方案,(a)使用原始 Cq 值的基于阈值的方法,(b)继续包括内源性(例如,miR-30b-5p)和外源性非人类 Spike-in(例如,cel-miR-39-3p)miRNA 进行质量控制,以及(c)重新运行任何不确定结果的样本。