Microfluidic-based exosome isolation and highly sensitive aptamer exosome membrane protein detection for lung cancer diagnosis.

Non-invasive methods of detecting cancer by circulating exosomes are challenged by inefficient purification and identification. This study hereby proposed an automated centrifugal microfluidic disc system combined with functionalized membranes (Exo-CMDS) to isolate and enrich exosomes, which will then be processed by a novel aptamer fluorescence system (Exo-AFS) in order to detect the exosome surface proteins in an effective manner. Exo-CMDS features in highly qualified yields with optimal exosomal concentration of 5.1 × 109 particles/mL from trace amount of blood samples (<300 µL) in only 8 min, which truly accomplishes the exosome isolation and purification in one-step methods. Meanwhile, the limit of detection (LOD) of PD-L1 in Exo-AFS reaches as low as 1.58 × 105 particles/mL. In the trial of clinical samples, the diagnostic accuracy of lung cancer achieves 91% (95% CI: 79%-96%) in contrast to the exosome ELISA (area under the curve: 0.9378 versus 0.8733; 30 patients). Exo-CMDS and Exo-AFS display the precedence in the aspects of inexpensiveness, celerity, purity, sensitivity and specificity when compared with the traditional techniques. Such assays potentially grant a practicable way of detecting inchoate cancers and guiding immunotherapy in clinic.

Circulating Tumor Cells and Fibronectin 1 in the Prognosis of Nasopharyngeal Carcinoma.

OBJECTIVE: Nasopharyngeal carcinoma is highly endemic in Southeast China. Circulating tumor cell is an important biomarker in the prognosis of variety kinds of cancers. Overexpression of fibronectin 1 was observed in variety kinds of malignancies and may contribute to progress and metastasis of the cancers. The current study was aimed to investigate phenotypes of circulating tumor cell in nasopharyngeal carcinoma blood and fibronectin 1 expression in the circulating tumor cell, and their clinical application in predicting nasopharyngeal carcinoma prognosis. METHODS: Blood samples were obtained from nasopharyngeal carcinoma patients before and after treatment. CanPatrol circulating tumor cell enrichment and RNA in situ hybridization were applied to identify circulating tumor cell and its phenotypes. Fibronectin 1 messenger RNA expression in the cells of circulating tumors was examined by messenger RNA-in situ hybridization. RESULTS: Circulating tumor cell was not associated with tumor characteristics or lymph node metastasis. Patients with >9 circulating tumor cells or >5 mesenchymal phenotype circulating tumor cell per 5-mL blood had poorer progression-free survival (P < .05). Multivariable analysis demonstrated that 2 or more mesenchymal phenotype circulating tumor cells with high fibronectin 1 messenger RNA expression predicted shorter progression-free survival (P < .05). CONCLUSIONS: Circulating tumor cells with high-level fibronectin 1 expression was associated with poor survival in patients with nasopharyngeal carcinoma and could be an independent prognostic factor for nasopharyngeal carcinoma.