Cystoscopy is the standard methodology for diagnosis of bladder cancer (BC), but it is invasive and relatively expensive. Previous studies have found that urinary exosomal long non-coding RNAs (lncRNAs) may act as potential noninvasive biomarkers for diagnosis. Here Researchers from the Shanghai Jiao Tong University School of Medicine identified urinary exosomal lncRNAs that are differentially expressed between BC and controls, and established a panel for diagnosis of BC.
The researchers performed RNA sequencing in urinary exosomes of 7 controls and 7 patients, subsequently the differentially expressed lncRNAs were detected in training cohort (50 controls and 50 patients) and validation cohort (43 controls and 43 patients). The diagnostic power of lncRNAs for BC was calculated by the area under curve (AUC). The panel for diagnosis of BC was calculated by logistic regression. The results of RNA sequencing in urinary exosomes showed that 240 upregulated lncRNAs and 275 downregulated lncRNAs were differentially expressed. The levels of MKLN1-AS, TALAM1, TTN-AS1 and UCA1 in BC patients were higher than that in controls in the training and validation cohort by real-time PCR. Using logistic regression, with the combination of these four lncRNAs and NMP22, the researchers identified a panel of five parameters capable of classifying BC patients versus controls on the basis of the training cohort (AUC=0.850). Moreover, the performance of the panel exhibited better performance than either single parameter in the validation cohort.
ROC curve analysis of the panel for the diagnosis of bladder cancer from controls
(A) The panel in the training cohort, AUC=0.850 (B) The panel in the validation cohort, AUC=0.823 (C) The panel for the diagnosis of NMIBC from controls, AUC=0.802 (D) The panel for the diagnosis of MIBC from controls, AUC=0.881 (E) The panel for the diagnosis of low grade bladder cancer from controls, AUC=0.768 (F) The panel for the diagnosis of high grade bladder cancer from controls, AUC=0.850.
Collectively, this study confirmed the diagnostic value of lncRNAs for BC by high-throughout urinary exosomal RNA sequencing.