The diagnostic value of serum exosomal miRNA-587 combined with hypersensitive C-reactive protein as noninvasive biomarker in early-stage non-small cell lung cancer

Objectives Lung cancer is a highly prevalent and life-threatening disease worldwide, with non-small cell lung cancer (NSLC) accounting for around 80 % of all cases. Exosomes contain important genetic information for humans that could be employed, especially for early screening of tumors. Accordingly, we aimed to use exosomal miRNA (ex-miRNA) in early NSCLC diagnosis.Methods The extracted ex-miRNAs were validated through transmission electron microscopy, particle size potentiometer, and western blot analyses. Microarray was used to verify ex-miRNAs, and 20 miRNAs were selected. Herein, we obtained 240 blood samples from NSCLC patients (101 in the early stage) and 234 from healthy donors. Our study deployed real-time fluorescence quantitative PCR (qRT-PCR) for detecting significantly down-regulated miR-587 expression. In addition, the hypersensitive C-reactive protein (Hs-CRP) levels were measured in patient samples.Results The results of calculating the area under the curve (AUC) revealed that the diagnostic efficiency of miR-587 and Hs-CRP were 0.771 and 0.863, respectively. Meanwhile, the combined diagnostic efficiency of both increased to 0.901. In patients with early NSCLC, the diagnostic efficiency of miR-587, Hs-CRP, and combined AUC were 0.726, 0.873, and 0.899, respectively. This indicates that the accuracy of early NSCLC diagnosis is very high. Finally, we combined miR-587 and Hs-CRP with CEA and NSE for NSCLC (AUC=0.956) and early-stage patients (AUC=0.921).Conclusions In this study, miR-587 and Hs-CRP have significant diagnostic efficiency for NSCLC, especially the combination of CEA and NSE that could indicate early NSCLC diagnosis.