Clinical Significance Of Plasma Exosomal-derived MiRNA In Patients With Early Lung Adenocarcinoma

Objective By comparing the expression levels of plasma exosome-derived miRNAs(miR-17-5p,miR-100-3p,and miR-30a-3p)in patients with lung adenocarcinoma and healthy volunteers,the accuracy of these three miRNAs in the diagnosis of early lung adenocarcinoma was judged。It is expected to provide new possibilities for early noninvasive diagnosis and screening of lung adenocarcinoma.Methods The plasma samples of 54 patients with stage I lung adenocarcinoma(confirmed by postoperative pathology)and 45 healthy volunteers in the Department of General Thoracic surgery of Ningxia Medical University General Hospital from October 2017 to October 2019 were selected.The plasma exosomes was extracted by ultracentrifugation and verified by electron microscope observation and western blotting detection of exosomes marker protein.The relative expression levels of miR-17-5p,miR-100-3p and miR-30a-3p in plasma exosomes bodies of patients with lung adenocarcinoma and healthy volunteers were detected by qPCR,and the accuracy of screening and diagnosis of early lung adenocarcinoma was analyzed by ROC curve.Results 1.The electron microscope results showed that the diameter of the extracted exosomes was about 50-150 nm,and they all had a cup-shaped double-layer membrane structure,which is a typical exosome image.Western blotting results showed that the exosomes marker molecules CD9 and CD63 were highly expressed in the extracted exosomes.2.The results of qPCR showed that the plasma exosomal-derived miR-17-5p in lungadenocarcinoma patients had a higher relative expression level than healthy volunteers,and the difference was statistically significant(P<0.01).The relative expression level of miR-100-3p in plasma exosomes was lower than that in healthy volunteers,and the difference was statistically significant(P<0.01);The relative expression level of miR-30a-3p in plasma exosomes of patients with lung adenocarcinoma was higher than that of healthy volunteers,but the difference was not statistically significant(P>0.05).3.ROC curve analysis results showed that the AUC value of miR-17-5p in the diagnosis of early-stage lung adenocarcinoma was 0.870,and the P value was <0.05,which was statistically significant.Its diagnostic sensitivity and specificity were 88.9% and 71.1%,respectively.The AUC value of miR-100-5p for the diagnosis of early-stage lung adenocarcinoma is 0.777,and the P value is<0.05,which is statistically significant.Its diagnostic sensitivity and specificity are 70.4% and77.8%,respectively.The AUC value of miR-17-5p/miR-100-3p combined with diagnosis of lung adenocarcinoma was 0.905,and the diagnostic sensitivity and specificity were 83.3%and 88.9%,respectively.Conclusion 1.In the plasma exosomal derived miRNA of patients with early lung adenocarcinoma,the relative expression of miR-17-5p is higher than that of healthy individuals,and the relative expression of miR-100-3p is lower than that of healthy individuals.2.Plasma exosome-derived miR-17-5p and miR-100-3p may be used as screening markers for early lung adenocarcinoma,and the combined screening accuracy is more accurate.