Li Lin, Zhang Zhijun, Xu Wei, Wang Jun, Feng Xiaodong
Department of Pharmacy Intravenous Admixture Services, The Affiliated Taian City Central Hospital of Qingdao University, Taian, 271000, China.
Department of Clinical Laboratory, The Affiliated Taian City Central Hospital of Qingdao University, Taian, 271000, China.
Clin Transl Oncol. 2025 Feb;27(2):650-659. doi: 10.1007/s12094-024-03606-1. Epub 2024 Jul 17.
Non-small cell lung cancer (NSCLC) is a widespread and serious global malignancy. This study aimed to examine the clinical relevance of serum exosomal SNORD116 and SNORA21 as novel diagnostic biomarkers for NSCLC.
Serum exosomes from 226 healthy controls and 305 NSCLC patients were isolated by ultracentrifugation. Characterization of exosomes was conducted by qNano, transmission electron microscopy (TEM) and Western immunoblotting. RT-PCR revealed snoRNAs that were differentially expressed. Receiver operating characteristic (ROC) analysis was used to assess the diagnostic performance.
In NSCLC patients, the levels of serum exosomal SNORD116 and SNORA21 were significantly reduced compared to those in healthy controls (P < 0.0001 for both). ROC curves showed AUC values of 0.738 and 0.761. By combining SNORD116 and SNORA21 with traditional blood biomarkers CYFRA21-1 and carcinoembryonic antigen (CEA), the AUC increased to 0.917. Moreover, these two exosomal snoRNAs distinguished between patients with metastatic NSCLC (n = 132) and those with non-metastatic NSCLC (n = 173) significantly (P < 0.0001 for both). The ROC curves gave AUC values of 0.743 and 0.694, respectively. The combined analysis raised the AUC to 0.751. The diagnostic power of these two exosomal snoRNAs combined with CYFRA21-1 and CEA increased to 0.784.
This study demonstrated that serum exosomal SNORD116 and SNORA21 can be used as potential promising non-invasive diagnostic biomarkers for NSCLC.
非小细胞肺癌（NSCLC）是一种广泛存在且严重的全球性恶性肿瘤。本研究旨在探讨血清外泌体中的SNORD116和SNORA21作为NSCLC新型诊断生物标志物的临床相关性。
通过超速离心从226名健康对照者和305例NSCLC患者中分离血清外泌体。采用qNano、透射电子显微镜（TEM）和Western免疫印迹法对外泌体进行表征。逆转录聚合酶链反应（RT-PCR）检测差异表达的小分子核仁RNA（snoRNAs）。采用受试者工作特征（ROC）分析评估诊断性能。
与健康对照者相比，NSCLC患者血清外泌体中SNORD116和SNORA21的水平显著降低（两者P均<0.0001）。ROC曲线显示曲线下面积（AUC）值分别为0.738和0.761。将SNORD116和SNORA21与传统血液生物标志物细胞角蛋白19片段（CYFRA21-1）和癌胚抗原（CEA）联合使用时，AUC增加至0.917。此外，这两种外泌体snoRNAs在转移性NSCLC患者（n = 132）和非转移性NSCLC患者（n = （此处原文有误，推测应为173））之间有显著差异（两者P均<0.0001）。ROC曲线的AUC值分别为0.743和0.694。联合分析使AUC提高至0.751。这两种外泌体snoRNAs与CYFRA21-1和CEA联合使用时的诊断效能提高至0.784。
本研究表明，血清外泌体中的SNORD116和SNORA21可作为NSCLC潜在的有前景的非侵入性诊断生物标志物。
