Plasma-derived exosomal long noncoding RNAs of pancreatic cancer patients as novel blood-based biomarkers of disease.

BACKGROUND: Pancreatic cancer (PaCa) is one of the most intractable and fatal malignancies and is associated with the dysregulation of long noncoding RNAs (lncRNAs), which are a large class of noncoding RNAs larger than 200 nt that act as competing endogenous RNAs or sponges for miRNAs to induce tumour biological behaviours. However, their clinical value in treating pancreatic cancer has been poorly explained, but they are essential for improving the prognosis of PaCa patients. METHODS: We analysed the plasma-derived exosomal lncRNA profiles of PaCa patients by using whole-transcriptome sequencing analysis and identified significantly differentially expressed lncRNAs, including LINC01268, LINC02802, AC124854.1, and AL132657.1. In the current study, the expression levels of four plasma-derived exosomal lncRNAs in PaCa plasma were validated via quantitative real-time polymerase chain reaction (qRT‒PCR). The relationship between the expression of the four lncRNAs and the clinicopathological features of patients with PaCa was also evaluated. RESULTS: We demonstrated that exosomal LINC01268, LINC02802, AC124854.1 and AL132657.1 were highly expressed in PaCa plasma compared with those in normal controls; moreover, they were positively correlated with the serum expression of carbohydrate antigen 19-9 (CA19-9). The receiver operating characteristic curves (AUCs) of the four lncRNAs were 0.8421, 0.6544, 0.7190, and 0.6321, and the AUC value of the combination of the four exosomal lncRNAs increased to 0.8476, with a sensitivity of 0.72 and specificity of 0.89. These results suggested that the plasma-derived exosomal genes LINC01268, LINC02802, AC124854.1, and AL132657.1 may be novel diagnostic markers for PaCa. CONCLUSIONS: Our research demonstrated that the plasma-derived exosomal lncRNAs of PaCa patients are novel blood-based biomarkers of disease.

Detection of early neurological deterioration using a quantitative electroencephalography system in patients with large vessel occlusion stroke after endovascular treatment.

BACKGROUND: Early neurological deterioration (END) is a serious complication in patients with large vessel occlusion (LVO) stroke. However, modalities to monitor neurological function after endovascular treatment (EVT) are lacking. This study aimed to evaluate the diagnostic accuracy of a quantitative electroencephalography (qEEG) system for detecting END. METHODS: In this prospective, nested case-control study, we included 47 patients with anterior circulation LVO stroke and 34 healthy adults from different clinical centers in Tianjin, China, from May 2023 to January 2024. Patients with stroke underwent EEG at admission and after EVT. The diagnostic accuracy of qEEG features for END was evaluated by receiver operating characteristic curve analysis, and the feasibility was evaluated by the percentage of artifact-free data and device-related adverse events. RESULTS: 14 patients with stroke had END (29.8%, 95% CI 16.2% to 43.4%), with most developed within 12 hours of recanalization (n=11). qEEG features showed significant correlations with National Institutes of Health Stroke Scale score and infarct volume. After matching, 13 patients with END and 26 controls were included in the diagnostic analysis. Relative alpha power demonstrated the highest diagnostic accuracy for the affected and unaffected hemispheres. The optimal electrode positions were FC3/4 in the unaffected hemisphere, and F7/8 and C3/4 in the affected hemisphere. No device-related adverse events were reported. CONCLUSION: The qEEG system exhibits a high diagnostic accuracy for END and may be a promising tool for monitoring neurological function. The identification of optimal electrode positions may enhance device convenience. CLINICAL TRIAL REGISTRATION: ChiCTR 2300070829.