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Zhou X, Liu M, Sun L, Cao Y, Tan S, Luo G, Liu T, Yao Y, Xiao W, Wan Z, Tang J. Circulating small extracellular vesicles microRNAs plus CA-125 for treatment stratification in advanced ovarian cancer. J Transl Med 2023; 21:927. [PMID: 38129848 PMCID: PMC10740240 DOI: 10.1186/s12967-023-04774-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND No residual disease (R0 resection) after debulking surgery is the most critical independent prognostic factor for advanced ovarian cancer (AOC). There is an unmet clinical need for selecting primary or interval debulking surgery in AOC patients using existing prediction models. METHODS RNA sequencing of circulating small extracellular vesicles (sEVs) was used to discover the differential expression microRNAs (DEMs) profile between any residual disease (R0, n = 17) and no residual disease (non-R0, n = 20) in AOC patients. We further analyzed plasma samples of AOC patients collected before surgery or neoadjuvant chemotherapy via TaqMan qRT-PCR. The combined risk model of residual disease was developed by logistic regression analysis based on the discovery-validation sets. RESULTS Using a comprehensive plasma small extracellular vesicles (sEVs) microRNAs (miRNAs) profile in AOC, we identified and optimized a risk prediction model consisting of plasma sEVs-derived 4-miRNA and CA-125 with better performance in predicting R0 resection. Based on 360 clinical human samples, this model was constructed using least absolute shrinkage and selection operator (LASSO) and logistic regression analysis, and it has favorable calibration and discrimination ability (AUC:0.903; sensitivity:0.897; specificity:0.910; PPV:0.926; NPV:0.871). The quantitative evaluation of Net Reclassification Improvement (NRI) and Integrated Discrimination Improvement (IDI) suggested that the additional predictive power of the combined model was significantly improved contrasted with CA-125 or 4-miRNA alone (NRI = 0.471, IDI = 0.538, p < 0.001; NRI = 0.122, IDI = 0.185, p < 0.01). CONCLUSION Overall, we established a reliable, non-invasive, and objective detection method composed of circulating tumor-derived sEVs 4-miRNA plus CA-125 to preoperatively anticipate the high-risk AOC patients of residual disease to optimize clinical therapy.
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Affiliation(s)
- Xiaofang Zhou
- Department of Gynecologic Oncology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, People's Republic of China
- Department of Oncology, Xiangya Cancer Center, Xiangya Hospital, Central South University, Changsha, 410008, People's Republic of China
| | - Mu Liu
- Department of Gynecologic Oncology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, People's Republic of China
| | - Lijuan Sun
- Department of Gynecology and Obstetrics, The Central Hospital of Shaoyang, Shaoyang, 422000, People's Republic of China
| | - Yumei Cao
- Department of Gynecology and Obstetrics, The Central Hospital of Shaoyang, Shaoyang, 422000, People's Republic of China
| | - Shanmei Tan
- Department of Gynecology and Obstetrics, The First People's Hospital of Huaihua, The Affiliated Huaihua Hospital of University of South China, Huaihua, 418000, People's Republic of China
| | - Guangxia Luo
- Department of Gynecology and Obstetrics, The First People's Hospital of Huaihua, The Affiliated Huaihua Hospital of University of South China, Huaihua, 418000, People's Republic of China
| | - Tingting Liu
- Department of Gynecology and Obstetrics, The First People's Hospital of Changde, Changde, 415000, People's Republic of China
| | - Ying Yao
- Department of Gynecology and Obstetrics, The First People's Hospital of Yueyang, Yueyang, 414000, People's Republic of China
| | - Wangli Xiao
- Department of Gynecology and Obstetrics, The First People's Hospital of Yueyang, Yueyang, 414000, People's Republic of China
| | - Ziqing Wan
- Department of Gynecologic Oncology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, People's Republic of China
| | - Jie Tang
- Department of Gynecologic Oncology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, People's Republic of China.
- Department of Gynecologic Oncology, Hunan Gynecologic Cancer Research Center, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Address: 283 Tongzipo Road, Yuelu District, Changsha, 410013, People's Republic of China.
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