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Determination of Serum Exosomal H19 as a Noninvasive Biomarker for Breast Cancer Diagnosis

Authors Zhong G, Wang K, Li J, Xiao S, Wei W, Liu J

Received 24 December 2019

Accepted for publication 12 March 2020

Published 27 March 2020 Volume 2020:13 Pages 2563—2571


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Yong Teng

Guobin Zhong,1 Keqiong Wang,1 Jiawei Li,1 Shuzhe Xiao,2 Wei Wei,1 Jianlun Liu3

1Department of Breast Surgery, Guangxi Medical University Cancer Hospital, Nanning, People’s Republic of China; 2Department of Pediatrics, Guangzhou First Municipal People’s Hospital, Guangzhou, People’s Republic of China; 3Department of Breast Surgery, Guangxi Medical University Cancer Hospital, Nanning, China; Department of General Surgery, The Langdong Hospital of Guangxi Medical University, Nanning, People’s Republic of China

Correspondence: Jianlun Liu; Wei Wei Email;

Purpose: There is an urgent need for new biomarkers for the diagnosis of breast cancer. Exosomes can communicate with cells through transport molecules, including long-chain noncoding RNA (lncRNA), which is considered as a promising noninvasive biomarker. Here, we aimed to determine the potential of long noncoding RNA (lncRNA) H19 in the circulating exosomes for the diagnosis of breast cancer (BC).
Materials and Methods: We measured the levels of lncRNA H19 in serum-derived exosomes from patients with breast cancer (BC) or benign breast disease (BBD) and healthy subjects, using quantitative real-time PCR. H19 levels were also measured for pre-operative and post-operative patients. Receiver operating characteristic curve was constructed, and the area under the curve (AUC) was calculated to determine the applicability of exosomal H19 levels as biomarkers in BC. The relationship between H19 relative expression and clinical features of BC patients was also analyzed.
Results: Exosomal H19 expression levels were upregulated in patients with BC compared to that in patients with BBD and healthy controls (BC vs BBD, P < 0.001; BC vs healthy subjects, P < 0.001). The median serum exosomal H19 levels were significantly lower in post-operative than that in the pre-operative patients (P < 0.001). The AUC for exosomal H19 analysis was 0.870 (95% CI: 0.774– 0.966) with a sensitivity of 87.0% and specificity of 70.6%, which was higher than the AUCs for CA15-3 and CEA, ie, 0.822 and 0.811, respectively. Moreover, exosomal H19 expression levels were associated with lymph node metastasis (P = 0.039), distant metastasis (P = 0.008), TNM stages (P = 0.022), ER (P=0.009), PR (P = 0.018), and Her-2 (P = 0.021).
Conclusion: Our results indicated that serum exosomal H19 acts as a novel biomarker for the diagnosis of BC.

Keywords: biological marker, breast neoplasm, diagnosis, long noncoding RNA

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