| Objective: Lung cancer can be clinically divided into two subtypes including small cell lung cancer and non-small cell lung cancer.The clinical characteristics and treatment methods of different pathological types of lung cancer are obviously different.The diagnosis of lung cancer often depends on invasive examination.The purpose of this study was to explore the significance of miRNAs derived from plasma exosomes in distinguishing between small cell lung cancer from non-small cell lung cancer by studying the differences in the expression of several plasma exosome-derived miRNA.Methods:Plasma from untreated NSCLC,SCLC and inflammatory patients(three in each group)was collected,and then exosomal miRNAs were isolated and analyzed by next-generation sequencing,and a group of alternate miRNAs with different expressions in each group were selected.Next,plasma samples were collected from more patients with NSCLC(59 cases),SCLC(22 cases)and inflammation(7 cases)and exosomal miRNAs were isolated;then the target miRNAs were detected by reverse transcription and quantitative PCR;finally,data were statistically analyzed.Results:There were a total of 88 patients,including 81 in the lung cancer group with 57 males and 24 females,and 7 in the inflammation group with 6 males and 1 female.There was no statistical difference in the distribution between males and females(P>0.05).The mean age of lung cancer group was 62.73±10.85 years old,and that of inflammation group was 74.86 ± 9.46 years old,without statistical difference in age distribution(P>0.05).There were 59 cases of non-small cell lung cancer and 22 cases of small cell lung cancer,among which 7 cases belong to I~II stage and 74 cases to stage III~IV.The expression of Has-9-12099,X-23356,Has-mir-1307-3p and Has-mir-18a-5p in the lung cancer group was statistically higher than that in the inflammatory group(P<0.05);Has-9-12099,X-23356 and Has-mir-18a-5p were more highly expressed in the non-small cell lung cancer group than those in the small lung cancer group(P<0.05).The expression of X-23556 and Has-mir-18a-5p in the small-cell lung cancer group was higher than that in the inflammatory group,with statistical significance(P<0.05).According to the grouping of small cell lung cancer and non-small cell lung cancer,the ROC curves was drawn,and the z-tests was used to verify whether there was a difference in the area under the three curves of Has-9-12099,X-23356 and has-mir-18a-5p.Results showed that there was no statistical difference in the area under the respective three curves(P>0.05).The AUC under the Has-9-12099 curve was 0.662(P<0.05,95% CI: 0.548~0.763),and the optimal cut off value was 8.73,with a sensitivity of 55.93% and a specificity of 81.82%.The AUC under the X-23356 curve was 0.643(P<0.05,95% CI: 0.528~0.746),and the optimal cut off value was 100.42,with a sensitivity of 49.15% and a specificity of 81.82%.The AUC under the Has-mir-18a-5p curve was 0.651(P<0.05,95%CI: 0.537~0.754),and the optimal cut off value was141.05,with a sensitivity of 84.75% and a specificity of 45.45%.Conclusions:The expression of Has-9-12099,X-23356 and Has-mir-18a-5p from plasma exosomes of patients with non-small cell lung cancer was higher compared to that in the small cell lung cancer group,and the difference was statistically significant.The sensitivity of X-23356,and Has-mir-18a-5p each alone as a predictive factor between non-small cell lung cancer and small cell lung cancer was 55.93%,49.15%,84.75%,the specificity was 81.82%,81.82%,45.45%,and the AUC was 0.662,0.643 and 0.651,respectively. |
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