Platelet RNA enables accurate detection of ovarian cancer: an intercontinental, biomarker identification study

Platelets are reprogrammed by cancer via a process called education, which favors cancer development. The transcriptional profile of tumor-educated platelets (TEPs) is skewed and therefore practicable for cancer detection. This intercontinental, hospital-based, diagnostic study included 761 treatment-naïve inpatients with histologically confirmed adnexal masses and 167 healthy controls from nine medical centers (China, n = 3; Netherlands, n = 5; Poland, n = 1) between September 2016 and May 2019. The main outcomes were the performance of TEPs and their combination with CA125 in two Chinese (VC1 and VC2) and the European (VC3) validation cohorts collectively and independently. Exploratory outcome was the value of TEPs in public pan-cancer platelet transcriptome datasets. The AUCs for TEPs in the combined validation cohort, VC1, VC2, and VC3 were 0.918 (95% CI 0.889-0.948), 0.923 (0.855-0.990), 0.918 (0.872-0.963), and 0.887 (0.813-0.960), respectively. Combination of TEPs and CA125 demonstrated an AUC of 0.922 (0.889-0.955) in the combined validation cohort; 0.955 (0.912-0.997) in VC1; 0.939 (0.901-0.977) in VC2; 0.917 (0.824-1.000) in VC3. For subgroup analysis, TEPs exhibited an AUC of 0.858, 0.859, and 0.920 to detect early-stage, borderline, non-epithelial diseases and 0.899 to discriminate ovarian cancer from endometriosis. TEPs had robustness, compatibility, and universality for preoperative diagnosis of ovarian cancer since it withstood validations in populations of different ethnicities, heterogeneous histological subtypes, and early-stage ovarian cancer. However, these observations warrant prospective validations in a larger population before clinical utilities.

Progress of tumor-educated platelets in tumor diagnosis / 国际外科学杂志

Platelets,which are derived from the multifunctional hematopoietic stem cells in the hematopoietic system of bone marrow,are small pieces of cytoplasm which was partially exfoliated from the bone marrow megakaryotic cells,and play an important role in the physiological hemostasis and coagulation process.Tumor cells transfer biomolecules (such as RNA) to platelets by direct contact or exosomes release,resulting in changes in platelet precursor RNA.Through the effect of tumor cells and microenvironment,precursor RNA of platelet is spliced to mature RNA and then transformed into functional protein to responds to external stimulation,which is forming tumor-educated platelets.The detection of tumor-educated platelets of peripheral blood of patients is expected to be used in clinical tumor diagnosis.The novel liquid biopsy method can be a replacement or supplement for current tumor detection methods.Further study of the role of tumor-educated platelets in the diagnosis of tumors will provide a new theoretical basis for clinical diagnosis of tumors.

Progress of Liquid Biopsy in Early Diagnosis of Lung Cancer / 中国肺癌杂志

The early diagnosis of lung cancer can improve the survival rate of patients. Using imaging method to screen high-risk population plays an important role in early detection and early diagnosis. More and more research shows that liquid biopsy can replace and supplement the method. Detection of circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), microRNA (miRNA), exosomes, and tumor educated platelets (TEPs) in patients' peripheral blood can be used for the early diagnosis of lung cancer, and may provide appropriate medical advice for high-risk population with negative imaging finding. The full text reviews the detection methods of these markers, their value in the early diagnosis, as well as their advantages and limitations, in order to promote the application of liquid biopsy in the early diagnosis and other fields.
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