Multiparametric plasma EV profiling facilitatesdiagnosis of pancreatic malignancy多参数分析facilitates eV的等离子体 诊断胰腺malignancy of

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1、SCIENCETRANSLATIONALMEDICINE

2、RESEARCHARTICLECANCER2017©TheAuthors,somerightsreserved;MultiparametricplasmaEVprofilingfacilitatesexclusivelicenseeAmericanAssociationdiagnosisofpancreaticmalignancyfortheAdvancementofScience.1,21,21,23KatherineS.Yang,*HyungsoonIm,*SeonkiHong,*IlariaPe

3、rgolini,14,51,21,21,6AndresFernandezdelCastillo,RuiWang,SusanClardy,Chen-HanHuang,CraigPille,311,71,2SoldanoFerrone,RobertYang,CesarM.Castro,HakhoLee,3,71,2,8†CarlosFernandezdelCastillo,RalphWeisslederPancreaticductaladenocarcinoma(PDAC)isusuallydetectedlateinthediseaseprocess.Clin

4、icalworkupthroughimagingandtissuebiopsiesisoftencomplexandexpensiveduetoapaucityofreliablebiomarkers.Weusedanadvancedmultiplexedplasmonicassaytoanalyzecirculatingtumor-derivedextracellularvesicles(tEVs)inmorethan100clinicalpopulations.UsingEV-basedproteinmarkerprofiling,weidentifie

5、dasignatureoffivemarkersEVEV(PDACsignature)forPDACdetection.Inourprospectivecohort,theaccuracyforthePDACsignaturewas84%[95%confidenceinterval(CI),69to93%]butonly63to72%forsingle-markerscreening.Oneofthebestmarkers,EVDownloadedfromGPC1alone,hadasensitivityof82%(CI,60to95%)andaspecif

6、icityof52%(CI,30to74%),whereasthePDACEVsignatureshowedasensitivityof86%(CI,65to97%)andaspecificityof81%(CI,58to95%).ThePDACsignatureoftEVsofferedhighersensitivity,specificity,andaccuracythantheexistingserummarker(CA19-9)orsingle–tEVmarkeranalyses.Thisapproachshouldimprovethediagnos

7、isofpancreaticcancer.INTRODUCTIONbiomarkers,arestructurallymorestable,andcontainproteinandhttp://stm.sciencemag.org/Pancreaticductaladenocarcinoma(PDAC)isthefourthleadingcausemRNAprofilesthathighlyreflectparentalcancercells(13–15).Exper-ofcancerdeathintheUnitedStates,witha5-yearsur

8、vivalratebelowimentalstudieshaveshedlightonthecompositionandfunctionalroles10%.Mostnewlydiagnosedpatients’(>80%)tumorsareconsideredoftEVs(16,17)for(i)diagnosis(13,18,19),(ii)long-rangecommuni-unresectable(1).Earlierdetectioncouldincreasesurvivalbyanesti-cation(16),and(iii)hostcelli

9、nteraction(20).Rapidandacc