Journal Article

Plasma extracellular vesicle long RNA profiling identifies a diagnostic signature for the detection of pancreatic ductal adenocarcinoma

Wang, Peng, Li, Yuchen, Qian, Ling, Wang, Zheng, Wang, Zhen, Huang, Shenglin, Chen, Kun, Kang, Bin, Zhao, Jingjing, Liao, Zhuan, He, Xianghuo, Zou, Wen-Bin, Chen, Zhen, Li, Yan, Meng, Zhiqiang, Yu, Shulin, Zong, Huajie

2020

Overview

ObjectivePancreatic ductal adenocarcinoma (PDAC) is difficult to diagnose at resectable stage. Recent studies have suggested that extracellular vesicles (EVs) contain long RNAs. The aim of this study was to develop a diagnostic (d-)signature for the detection of PDAC based on EV long RNA (exLR) profiling.DesignWe conducted a case-control study with 501 participants, including 284 patients with PDAC, 100 patients with chronic pancreatitis (CP) and 117 healthy subjects. The exLR profile of plasma samples was analysed by exLR sequencing. The d-signature was identified using a support vector machine algorithm and a training cohort (n=188) and was validated using an internal validation cohort (n=135) and an external validation cohort (n=178).ResultsWe developed a d-signature that comprised eight exLRs, including FGA, KRT19, HIST1H2BK, ITIH2, MARCH2, CLDN1, MAL2 and TIMP1, for PDAC detection. The d-signature showed high accuracy, with an area under the receiver operating characteristic curve (AUC) of 0.960, 0.950 and 0.936 in the training, internal validation and external validation cohort, respectively. The d-signature was able to identify resectable stage I/II cancer with an AUC of 0.949 in the combined three cohorts. In addition, the d-signature showed superior performance to carbohydrate antigen 19-9 in distinguishing PDAC from CP (AUC 0.931 vs 0.873, p=0.028).ConclusionThis study is the first to characterise the plasma exLR profile in PDAC and to report an exLR signature for the detection of pancreatic cancer. This signature may improve the prognosis of patients who would have otherwise missed the curative treatment window.

• Publisher: BMJ Publishing Group Ltd and British Society of Gastroenterology,BMJ Publishing Group LTD
• Subject: Accuracy / Adenocarcinoma / Adolescent / Adult / Aged / Aged, 80 and over / Alpha-Globulins - genetics / Antigens / Area Under Curve / Biomarkers / CA-19-9 Antigen - blood / Cancer therapies / Carbohydrates / Carcinoma, Pancreatic Ductal - blood / Carcinoma, Pancreatic Ductal - diagnosis / Carcinoma, Pancreatic Ductal - genetics / Case-Control Studies / Chemotherapy / Child / Claudin-1 - genetics / diagnosis / extracellular vesicle / Extracellular Vesicles - metabolism / Female / Fibrinogen - genetics / Gene expression / Genomes / Humans / Keratin-19 - genetics / Library collections / long RNA / Male / Membrane Proteins - genetics / Middle Aged / Myelin and Lymphocyte-Associated Proteolipid Proteins - genetics / Pancreas / Pancreatic cancer / pancreatic ductal adenocarcinoma / Pancreatic Neoplasms - blood / Pancreatic Neoplasms - diagnosis / Pancreatic Neoplasms - genetics / Pancreatitis / Pancreatitis, Chronic - blood / Patients / Proteins / Ribonucleic acid / RNA / RNA - blood / RNA, Circular - blood / RNA, Long Noncoding - blood / RNA, Messenger - blood / ROC Curve / Sequence Analysis, RNA / Studies / Support Vector Machine / Tissue inhibitor of metalloproteinase 1 / Tissue Inhibitor of Metalloproteinase-1 - genetics / Tumors / Ubiquitin-Protein Ligases - genetics / Young Adult