Promising Biomarker For Early Detection Research Articles

Abstract 3897: Isolation and molecular characterization of exosomes from glioblastoma patients using a microfluidic device after ultrasound-based opening of the blood-brain barrier

Abstract Glioblastoma (GBM) is a highly aggressive tumor of the brain. Current techniques of detection like magnetic resonance imaging and tissue biopsy are inaccurate or highly invasive, requiring alternatives like liquid biopsy. Exosomes are nanosized vesicles that contain cargo, reflective of their cellular origin and have been used for early diagnosis of cancer. However, in GBM, the blood-brain barrier (BBB) leads to a paucity of pathological information in blood. This study investigates the effect of opening the BBB on circulating exosomes and their potential for early detection of GBM using a microfluidic platform (GlioExoChip). In 20 patients enrolled in a clinical trial NCT03744026, a pulsed ultrasound emitter- Sonocloud-9 was implanted into their brains to open the BBB. We show that GlioExoChip isolates GBM-specific exosomes with a high capture efficiency using phosphatidylserine and Annexin-V chemistry. Further, the amount of circulating EVs increases twofold after opening the BBB. Finally, the correlation between tumor growth rate and the exosome concentrations is evaluated longitudinally. Methods: GlioExoChip is a microfluidic platform with a polydimethylsiloxane top and a glass bottom, functionalized with neutravidin-biotinylated annexin-V. Experiments are performed with GBM cell-line derived exosomes, followed by patient plasma. Isolated exosomes are characterized using Nanoparticle tracking analysis (NTA), scanning electron microscopy, Bicinchoninic acid (BCA) assay and western blot. Statistical analyses are performed using Student’s t-test and Pearson correlation. Results: The microfluidic device GlioExoChip has a high capture efficiency of exosomes derived from GBM cell lines, i.e., 93.03±3.31% and 96.77±0.72% for GBM6 and U87, respectively. NTA and BCA showed that 15 times more exosomes were captured from patient plasma when compared with healthy. Further, western blot proved the presence of a glial protein and Flotillin-1 in exosomes isolated from patients. Exosome concentrations varied with different time points after sonication and had an average twofold increase from the BBB opening. In our longitudinal study with 8 patients, an association between the volumetric enhancement of the tumor and exosome concentrations after sonication shows that the average Pearson correlation among short progression-free survival (PFS) patients was 0.73 (avg. p=0.39), while no correlation was seen among long PFS patients (avg. r value=0.10; avg. p-value=0.54). Conclusions: A microfluidic approach was used to investigate the role of circulating exosomes using phosphatidylserine-annexin V chemistry in GBM. BBB opening via sonication leads to an increase in the average GBM-specific exosome concentrations in plasma. Thus, exosomes are promising biomarkers for early detection in GBM. Citation Format: Abha Kumari, Mark Youngblood, Andrew Gould, Yoon-Tae Kang, Li Chen, Karl Habashy, Chris Amidei, Rachel Ward, Cristal Gomez, Guillaume Bouchoux, Michael Canney, Roger Stupp, Adam M. Sonabend, Sunitha Nagrath. Isolation and molecular characterization of exosomes from glioblastoma patients using a microfluidic device after ultrasound-based opening of the blood-brain barrier [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3897.

Secreted proteins encoded by super enhancer-driven genes could be promising biomarkers for early detection of esophageal squamous cell carcinoma

BackgroundEarly detection of cancer remains an unmet need in clinical practice, and high diagnostic sensitivity and specificity biomarkers are urgently required. Here, we attempted to identify secreted proteins encoded by super-enhancer (SE)-driven genes as diagnostic biomarkers for esophageal squamous cell carcinoma (ESCC). MethodsWe conducted an integrative analysis of multiple data sets including ChIP-seq data, secretome data, CCLE data and GEO data to screen secreted proteins encoded by SE-driven genes. Using ELISA, we further identified up-regulated secreted proteins through a small size of clinical samples and verified in a multi-centre validation stage (345 in test cohort and 231 in validation cohort). Receiver operating characteristic curves were used to calculate diagnostic accuracy. Artificial intelligence (AI) method named gradient boosting machine (GBM) were applied for model construction to enhance diagnostic accuracy. ResultsSerum EFNA1 and MMP13 were identified, and showed significantly higher levels in ESCC patients compared to normal controls. An integrated Five-Biomarker Panel (iFBPanel) established by combining EFNA1, MMP13, carcino-embryonic antigen, Cyfra21-1 and squmaous cell carcinoma antigen had AUCs of 0.881 and 0.880 for ESCC in test and validation cohorts, respectively. Importantly, the iFBPanel also exhibited good performance in detecting early-stage ESCC patients (0.872 and 0.864). Furthermore, the iFBPanel was further empowered by AI technology which showed excellent diagnostic performance in early-stage ESCC (0.927 and 0.907). ConclusionsOur study suggested that serum EFNA1 and MMP13 could potentially assist ESCC detection, and provided an easy-to-use detection model that might help the diagnosis of early-stage ESCC.

Tumor Endothelial Cells-Associated Integrin Alpha-6 as a Promising Biomarker for Early Detection and Prognosis of Hepatocellular Carcinoma.

HCC remains a lethal cancer type, with early detection being critical for improved patient outcomes. This study introduces a comprehensive methodological approach to identify the ITGA6 gene as a potential blood marker for early HCC (eHCC) detection. We initially analyzed the GSE114564 dataset encompassing various stages of liver disease, identifying 972 differentially expressed genes in HCC. A refined analysis yielded 59 genes specifically differentially expressed in early HCC, including ITGA6. Subsequent validation in multiple datasets confirmed the consistent upregulation of ITGA6 in HCC. In addition, when analyzing progression-free survival (PFS) within the entire patient cohort and overall survival (OS) specifically among patients classified as tumor grade G1, the group of patients characterized by high expression levels of ITGA6 displayed an elevated risk ratio in relation to prognosis. Further analyses demonstrated the predominant expression of ITGA6 in TECs and its enrichment in angiogenesis-related pathways. Additionally, positive correlations were found between ITGA6 expression and pro-tumorigenic immune cells, but not with anti-tumorigenic immune cells. Our study elucidates the potential of ITGA6 as a blood-based marker for HCC early detection and diagnosis and its complex interplay with the tumor microenvironment. Further research may lead to novel strategies for HCC management and patient care.

Comparative proteomics analysis in different stages of urothelial bladder cancer for identification of potential biomarkers: highlighted role for antioxidant activity

BackgroundNon-muscle-invasive bladder cancer (NMIBC) has a high recurrence rate and muscle-invasive bladder cancer (MIBC) has unfavorable outcomes in urothelial bladder cancer (UBC) patients. Complex UBC-related protein biomarkers for outcome prediction may provide a more efficient management approach with an improved clinical outcome. The aim of this study is to recognize tumor-associated proteins, which are differentially expressed in different stages of UBC patients compared non-cancerous tissues.MethodsThe proteome of tissue samples of 42 UBC patients (NMIBC n = 25 and MIBC n = 17) was subjected to two-dimensional electrophoresis (2-DE) combined with Liquid chromatography–mass spectrometry (LC–MS) system to identify differentially expressed proteins. The intensity of protein spots was quantified and compared with Prodigy SameSpots software. Functional, pathway, and interaction analyses of identified proteins were performed using geneontology (GO), PANTHER, Reactome, Gene MANIA, and STRING databases.ResultsTwelve proteins identified by LC-MS showed differential expression (over 1.5-fold, p < 0.05) by LC-MS, including 9 up-regulated in NMIBC and 3 up-regulated in MIBC patients. Proteins involved in the detoxification of reactive oxygen species and cellular responses to oxidative stress showed the most significant changes in UBC patients. Additionally, the most potential functions related to these detected proteins were associated with peroxidase, oxidoreductase, and antioxidant activity.ConclusionWe identified several alterations in protein expression involved in canonical pathways which were correlated with the clinical outcomes suggested might be useful as promising biomarkers for early detection, monitoring, and prognosis of UBC.

Electrophysiological Signatures of Anxiety in Parkinson’s Disease (S51.008)

<h3>Objective:</h3> To assess the pattern of disturbances in the functional brain networks of Parkinson’s disease patients with anxiety (PD-A) compared to those without anxiety (PD-NA) and healthy controls (HC). <h3>Background:</h3> Anxiety is a common non motor symptom in PD occurring in up to 60% of the patients and affecting their quality of life. Despite their high prevalence, anxiety symptoms are often undiagnosed and untreated in PD. To date, functional and structural neuroimaging studies have contributed to our understanding of the motor and cognitive symptomatology of PD. Yet, the underlying pathophysiology of the anxiety symptoms in PD remains largely unknown and studies on their neural correlates are missing. <h3>Design/Methods:</h3> The present study comprised 68 non-demented PD patients and 25 healthy controls. PD patients were divided into two subgroups based on their Beck Anxiety Inventory (BAI) scale (cut-off=13): PD patients with anxiety (N=18) and without anxiety (N=50). Using their resting state high density electroencephalography (EEG) recordings at baseline, we assessed the frequency-dependent functional connectivity patterns that characterize the PD-A patients compared to both PD-NA patients and HC and we validated their relevance after 3 years. <h3>Results:</h3> We revealed different frequency-dependent pattern of connectivity that can characterize the PD-A group compared to PD-NA and HC: patterns with high functional connectivity were observed in delta, theta and gamma bands involving mainly fronto-temporal connections, whereas fronto-parietal patterns with low functional connectivity were pertinent in alpha and beta bands. Their corresponding network signature metric were strongly correlated with the anxiety scale of all the participants at baseline and after 3 years showing a predictive power of the revealed networks. <h3>Conclusions:</h3> Our findings suggest that PD-related anxiety can be characterized by a signature of different frequency-dependent pattern of disturbances in the functional brain networks. Resting state EEG could be a very promising biomarker for early detection of anxiety in PD. <b>Disclosure:</b> Mrs. Yassine has nothing to disclose. Mrs. Almarouk has nothing to disclose. Ute Gschwandtner has nothing to disclose. Dr. Auffret has received personal compensation for serving as an employee of France Développement Electronique. The institution of Dr. Auffret has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Britannia. Dr. Auffret has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Britannia. Dr. Auffret has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Britannia. Dr. Auffret has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Aguettant. The institution of Dr. Auffret has received research support from Association France Parkinson. The institution of Dr. Auffret has received research support from Homeperf. The institution of Dr. Auffret has received research support from LVL. The institution of Dr. Auffret has received research support from University of Rennes 1. The institution of Dr. Auffret has received research support from Aguettant. The institution of Dr. Auffret has received research support from Linde. The institution of Dr. Auffret has received research support from Plateforme Nationale pour la recherche sur la fin de vie. Dr. Auffret has received publishing royalties from a publication relating to health care. Mr. HASSAN has nothing to disclose. The institution of Dr. Fuhr has received research support from Roche. Mr. Verin has nothing to disclose.

Presepsin as a promising biomarker for early detection of post-operative infection in children.

Post-operative systemic inflammation response syndrome (SIRS) is an event that results from surgical trauma, white blood cells contact activation, and intra-surgical bacterial translocation, which is difficult to distinguish from sepsis. Presepsin is a novel biomarker that is increased since the early stages of bacterial infection and can be used to confirm the diagnosis of post-operative infectious complications. This study aimed to investigate the diagnostic performance of presepsin for post-operative infectious complications compared to other well-known biomarkers. This cross-sectional study included 100 post-operative patients admitted to Cipto Mangunkusumo National Hospital and Bunda Hospital in Jakarta, Indonesia. The objective was to identify the optimal cutoff and trend of plasma presepsin concentration on the first and third day after surgery and to compare them with other biomarkers. Plasma presepsin level was higher in the infection group compared to the non-infection group (median 806.5 pg/ml vs. 717 pg/ml and 980 pg/ml vs. 516 pg/ml on the first and third day, respectively). Presepsin levels tended to increase on the third post-operative day (median + 252 pg/ml) in children with infection. The opposite trend was observed in the non-infection group from the first to the third day (median -222.5 pg/ml). Presepsin delta, a three-day difference between the first and third post-operative day, had the best diagnostic performance compared to other biomarkers (Area Under the Curve 0.825). The optimal cutoff for presepsin delta to diagnose post-operative infection was +90.5 pg/ml. Serial assessments of presepsin levels on the first and third days post-surgery and their trends are helpful diagnostic markers for clinicians to detect post-operative infectious complications in children.

Omics sciences and precision medicine in thyroid cancer.

Thyroid cancer, a heterogeneous disease originating from the thyroid gland, stands as the predominant endocrine malignan-cy worldwide. Despite advances in diagnosis and treatment, some patients still experience recurrence and mortality, which highlights the need for more personalized approaches to treatment. Omics sciences, encompassing genomics, transcriptomics, proteomics, and metabolomics, offer a high-throughput and impartial methodology for investigating the molecular signatures of thyroid cancer. In the course of this review, we have adopted a focu-sed research strategy, meticulously selecting the most pertinent and emblematic articles related to the topic. Our methodology included a systematic examination of the scientific literature to guarantee a thorough and precise synthesis of the existing sources. These techniques enable the identification of molecular markers that can aid in diagnosis, prognosis, and treatment selection. As an illustration, through genomics studies, numerous genetic alterations commonly discovered in thyroid cancer have been identified, such as mutations in the BRAF and RAS genes. Through transcriptomics studies, distinctively expressed genes in thyroid cancer have been uncovered, playing roles in diverse biological processes, including cell proliferation, invasion, and metastasis. These genes can serve as potential targets for novel therapies. Proteomics studies have unveiled differentially expressed proteins intricately involved in thyroid cancer pathogenesis, presenting promising biomarkers for early detection and disease progression monitoring. Metabolomics studies have identified alterations in metabolic pathways linked to thyroid cancer, offering promising avenues for potential therapeutic targets. Precision medicine in thyroid cancer involves the integration of omics sciences with clinical data to develop personalized treatment plans for patients. Employing targeted therapies guided by molecular markers has exhibited promising outcomes in enhancing the prognosis of thyroid cancer patients. Notably, those with advanced hyroid cancer carrying BRAF mutations have displayed substantial responses to specific targeted therapies, such as vemurafenib and dabrafenib.

Quantitative Radiomic Features From Computed Tomography Can Predict Pancreatic Cancer up to 36 Months Before Diagnosis.

Pancreatic cancer is the third leading cause of cancer deaths among men and women in the United States. We aimed to detect early changes on computed tomography (CT) images associated with pancreatic ductal adenocarcinoma (PDAC) based on quantitative imaging features (QIFs) for patients with and without chronic pancreatitis (CP). Adults 18 years and older diagnosed with PDAC in 2008-2018 were identified. Their CT scans 3 months-3 years before the diagnosis date were matched to up to 2 scans of controls. The pancreas was automatically segmented using a previously developed algorithm. One hundred eleven QIFs were extracted. The data set was randomly split for training/validation. Neighborhood and principal component analyses were applied to select the most important features. A conditional support vector machine was used to develop prediction algorithms separately for patients with and without CP. The computer labels were compared with manually reviewed CT images 2-3 years before the index date in 19 cases and 19 controls. Two hundred twenty-seven of 554 scans of non-CP cancer cases/controls and 70 of 140 scans of CP cancer cases/controls were included (average age 71 and 68 years, 51% and 44% females for non-CP patients and patients with CP, respectively). The QIF-based algorithms varied based on CP status. For non-CP patients, accuracy measures were 94%-95% and area under the curve (AUC) measures were 0.98-0.99. Sensitivity, specificity, positive predictive value, and negative predictive value were in the ranges of 88%-91%, 96%-98%, 91%-95%, and 94%-96%, respectively. QIFs on CT examinations within 2-3 years before the index date also had very high predictive accuracy (accuracy 95%-98%; AUC 0.99-1.00). The QIF-based algorithm outperformed manual rereview of images for determination of PDAC risk. For patients with CP, the algorithms predicted PDAC perfectly (accuracy 100% and AUC 1.00). QIFs can accurately predict PDAC for both non-CP patients and patients with CP on CT imaging and represent promising biomarkers for early detection of pancreatic cancer.

MiR-1294 inhibits the progression of breast cancer via regulating ERK signaling

Breast cancer (BC) is the most diagnosed carcinoma in women worldwide, which is characterized with a high incidence rate and poor prognosis. MicroRNAs (miRNAs) are promising biomarkers for early detection of BC. In this study, we demonstrated that MiR1294 was downregulated in BC. Moreover, we revealed that MiRNA1294 significantly suppressed cell proliferation, migration and invasion. Animal models revealed that MiRNA1294 reduced tumor formation. In addition, we found that ERK signaling was involved in the regulatory role of MiRNA1294 in BC. In conclusion, MiRNA1294 acted as a tumor suppressor in BC, which might serve as a potential target for the development of anti-neoplastic therapies in BC.

The High Ratio of the Plasma miR-96/miR-99b Correlated With Poor Prognosis in Patients With Metastatic Colorectal Cancer.

Object: This study aims to clarify the expression of plasma miRNA in CRC patients, and to clarify the potential use of these miRNAs in diagnosis and prognosis, and to establish a prognostic model to initially explore its clinical value. Methods: We detected the expression of 6 miRNAs in normal colon epithelial cell lines and colorectal cancer cell lines by qRT-PCR and they were validated in the tissues of three subtypes: 20 healthy subjects, 41 pCRC and 49 mCRC patients. COX regression and ROC analyses use to evaluate the diagnostic and prognostic efficacy of candidate miRNAs. Subsequently, we initially established a nomogram prognostic model. MiRNA is also used to construct miRNA-mRNA interaction network and PPI network modules. Results: Five miRNAs showed significant differential expression in pCRC, mCRC patients and normal groups. ROC analysis showed that CEA, miR-96, miR-99b and miR-96/miR-99b are distinguishable from pCRC and mCRC patients, with AUC ranging from 0.65 to 0.91; among them, the ratio of miR-96/miR-99b is stronger than any diagnostic indicators, such as CEA and CA125. Multivariate survival analysis identified miR-96, miR-99b, N stage, M stage and clinical stage as independent prognostic indicators of mCRC. The nomogram based on these 5 characteristics has satisfactory prognostic values. Conclusion: Our data indicate that plasma miR-96/miR-99b can be used as a promising biomarker for early detection of mCRC patients; our nomogram has a promising evaluation value.

Clinical and analytical comparison of three assays for plasma p‐tau isoforms on an ultrasensitive platform

AbstractBackgroundPlasma phosphorylated Tau (P‐tau) protein is a promising biomarker for early detection of Alzheimer’s Disease (AD), reflecting abnormal tau metabolism in CSF and brain. Different Tau isoforms have been shown as specific biomarkers to detect AD including plasma tau phosphorylated at threonine 181 (P‐tau181) and at threonine 217 (P‐tau217). Novel plasma tests have been developed on various platforms for different isoforms and using various reagents, but these have not been compared directly for their analytical and clinical performance. In this study, we directly compared three novel P‐tau blood assays to investigate the clinical and technical differences between each assay.MethodWe included the following assays: plasma P‐tau181 from Quanterix, P‐tau181 Lilly and P‐tau217 Lilly assays, all run on the Simoa HD‐X (Quanterix). We analytically compared the novel assays for the parameters: precision, linearity, parallelism, limit of detection, recovery and sensitivity. The clinical performance of each assay was evaluated using plasma samples from 40 non‐demented healthy individuals of www.hersenonderzoek.nl (median age 66 years, 68 % females) and 40 AD‐dementia cases of the Amsterdam dementia cohort (median age 66, 60 % females). Using a receiver operating characteristics (ROC) curve analysis, we compared the discriminatory ability of each assay. Here, we present the clinical performance results.ResultPlasma P‐tau217 and both plasma P‐tau181 assays were highly correlated, with correlation coefficients over 0.82 (all p&lt; 0.001). Patients with AD‐dementia showed elevated levels of P‐tau181 and P‐tau217 in comparison to healthy controls (P‐tau 217 AUC = 0.995 (0.986‐1.00), P‐tau181 Quanterix AUC=0.936 (0.885‐987), P‐tau 181 Lilly AUC= 0.938 (0.87‐1.00)). The P‐tau217 Lilly assay numerically outperformed both the P‐tau 181 assays in discriminating between AD‐dementia and control cases with a sensitivity of 97.5% at a specificity of 95%. The P‐tau181 Quanterix and Lilly showed a sensitivity of 100% at 89.5%, 79% specificity, respectively.ConclusionOur findings suggest that the novel plasma P‐tau isoform tests are useful for the diagnostic work up of AD‐dementia.

Plasma ADAMTS13 and von Willebrand factor in diagnosis and prediction of prognosis in pulmonary arterial hypertension.

To improve outcome in pulmonary arterial hypertension, earlier diagnosis and better prognostic assessments are required. We aimed to investigate the diagnostic and prognostic potential of plasma proteins related to pathways recognized in pulmonary arterial hypertension including coagulation, inflammation, and metabolism. Forty-two proteins were analysed with proximity extension assay from plasma of 20 healthy controls and 150 patients, including (pulmonary arterial hypertension, n = 48, whereof 33 also during early treatment follow-ups); chronic thromboembolic pulmonary hypertension (CTEPH, n = 20); pulmonary hypertension (PH) due to heart failure (HF) with preserved ejection fraction (HFpEF-PH, n = 31); PH due to HF with reduced ejection fraction (HFrEF-PH, n = 36); and HF without PH (Dyspnoea/HF-non-PH, n = 15). Patients’ haemodynamics were assessed by right heart catheterization. Plasma ADAMTS13 in incident pulmonary arterial hypertension was lower compared to the healthy controls (p = 0.055), as well as CTEPH (p < 0.0001), HFrEF-PH (p < 0.0001), HFrEF-PH (p < 0.0001), and Dyspnoea/HF-non-PH (p < 0.0001). Adjusted for age and sex, ADAMTS13 discriminated pulmonary arterial hypertension from the other disease groups with an AUC of 0.91 (sensitivity = 87.5%, and specificity = 78.4%). Higher plasma von Willebrand factor was associated with worse survival (log-rank p = 0.0029), and a higher mortality rate (adjusted hazard ratio 1.002, 95% confidence interval 1–1.004; p = 0.041). Adjusted for age, sex, and combined with the ESC/ERS risk score, von Willebrand factor predicted mortality (median follow-up 3.6 years) in pulmonary arterial hypertension with an AUC of 0.94 (sensitivity = 81.3%, and specificity=93.8%). ADAMTS13 may be a promising biomarker for early detection of PAH and von Willebrand factor as a candidate prognostic biomarker. The putative additional value of von Willebrand factor to the European multiparametric risk assessment strategy remains to be elucidated.

Systemic Investigation Identifying Salivary miR-196b as a Promising Biomarker for Early Detection of Head-Neck Cancer and Oral Precancer Lesions.

Background: Liquid biopsy is a rapidly growing field, for it may provide a minimally invasive way to acquire pathological data for personalized medicine. This study developed a systemic strategy to discover an effective salivary biomarker for early detection of patients with head-neck squamous carcinoma (HNSC) and oral precancer lesion (OPC). Methods: A total of 10 miRNAs were examined in parallel with multiple independent cohorts. These included a training set of salivary samples from HNSC patients, the TCGA-HNSC and GSE31277 cohorts to differentiate miRNAs between tumor and normal tissues, and groups of salivary samples from healthy individuals, patients with HNSC and OPC. Results: The combined results from the salivary training set and the TCGA-HNSC cohort showed that four miRNAs (miR-148b, miR-155, miR-196b, and miR-31) consistently increased in HNSC patients. Further integration with the GSE31277 cohort, two miRNAs (miR-31 and miR-196b) maintained at high significances. Further assessment showed that salivary miR-196b was a prominent diagnostic biomarker, as it remarkably discriminated between healthy individuals and patients with HNSC (p < 0.0001, AUC = 0.767, OR = 5.64) or OPC (p < 0.0001, AUC = 0.979, OR = 459). Conclusion: Salivary miR-196b could be an excellent biomarker for diagnosing OPC and early detection of HNSC. This molecule may be used for early screening high-risk groups of HNSC.

Comparison of Genetic Profiling between Primary Tumor and Circulating Tumor Cells Captured by Microfluidics in Epithelial Ovarian Cancer: Tumor Heterogeneity or Allele Dropout?

Epithelial ovarian cancer (EOC) is a leading cause of cancer mortality among women but unfortunately is usually not diagnosed until advanced stage. Early detection of EOC is of paramount importance to improve outcomes. Liquid biopsy of circulating tumor cells (CTCs) is emerging as one of the promising biomarkers for early detection of solid tumors. However, discrepancies in terms of oncogenomics (i.e., different genetic defects detected) between the germline, primary tumor, and liquid biopsy are a serious concern and may adversely affect downstream cancer management. Here, we illustrate the potential and pitfalls of CTCs by presenting two patients of Stage I EOC. We successfully isolated and recovered CTCs by a silicon-based nanostructured microfluidics system, the automated Cell RevealTM. We examined the genomics of CTCs as well as the primary tumor and germline control (peripheral blood mononuclear cells) by whole exome sequencing. Different signatures were then investigated by comparisons of identified mutation loci distinguishing those that may only arise in the primary tumor or CTCs. A novel model is proposed to test if the highly variable allele frequencies, between primary tumor and CTCs results, are due to allele dropout in plural CTCs or tumor heterogeneity. This proof-of-principle study provides a strategy to elucidate the possible cause of genomic discrepancy between the germline, primary tumor, and CTCs, which is helpful for further large-scale use of such technology to be integrated into clinical management protocols.

Urine miR-93-5p is a promising biomarker for early detection of HBV-related hepatocellular carcinoma

IntroductionThe mortality rate of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC)continues to increase because sensitive, early and readily available diagnostic tools are lacking. To address this problem, we aimed to identify diagnosticbio markers to be used for early detection of HCC. Materials and methodsmiR-93–5p was selected as a candidate biomarker based on the analyses of relevant Gene Expression Omnibus (GEO) datasets; it was validated using qPCR to quantify its expression levels in tissue, plasma and saliva sample sets. ResultsmiR-93–5p was significantly upregulated in HBV-related HCC tissue. Notably, miR-93–5p in plasma and urine was also significantly increased in patients with early HBV-related HCC. The expression of miR-93–5p was significantly and positively correlated in pairwise comparisons of samples (tissue vs. plasma, tissue vs. urine, plasma vs. urine). Moreover, after curative hepatectomy,miR-93–5p in plasma and urine decreased significantly over one month after the curative hepatectomy and returned to normal levels. Furthermore, receiver operating characteristic (ROC) analysis indicated that both plasma and urine miR-39–5p could detect be used to early, advanced and overall HBV-related HCC cases with more than 85% sensitivities and 93% of specificities. Finally, urine miR-93–5p could be used to predict progress-free survival for early HCC patients who received curative hepatectomy and overall survival for advanced HCC patients without curative treatments. ConclusionsPlasma and urine miR-93–5p show great promise as potential novel biomarkers for early detection of HBV-related HCC. Moreover, urine miR-93–5p could be used to predict the prognosis of patients with HBV-related HCC.

Single-Molecule Counting Coupled to Rapid Amplification Enables Detection of α-Synuclein Aggregates in Cerebrospinal Fluid of Parkinson's Disease Patients.

α‐Synuclein aggregation is a hallmark of Parkinson's disease and a promising biomarker for early detection and assessment of disease progression. The prospect of a molecular test for Parkinson's disease is materializing with the recent developments of detection methods based on amplification of synuclein seeds (e.g. RT‐QuIC or PMCA). Here we adapted single‐molecule counting methods for the detection of α‐synuclein aggregates in cerebrospinal fluid (CSF), using a simple 3D printed microscope. Single‐molecule methods enable to probe the early events in the amplification process used in RT‐QuIC and a precise counting of ThT‐positive aggregates. Importantly, the use of single‐molecule counting also allows a refined characterization of the samples and fingerprinting of the protein aggregates present in CSF of patients. The fingerprinting of size and reactivity of individual aggregate shows a unique signature for each PD patients compared to controls and may provide new insights on synucleinopathies in the future.

Single‐Molecule Counting Coupled to Rapid Amplification Enables Detection of α‐Synuclein Aggregates in Cerebrospinal Fluid of Parkinson's Disease Patients

Abstractα‐Synuclein aggregation is a hallmark of Parkinson's disease and a promising biomarker for early detection and assessment of disease progression. The prospect of a molecular test for Parkinson's disease is materializing with the recent developments of detection methods based on amplification of synuclein seeds (e.g. RT‐QuIC or PMCA). Here we adapted single‐molecule counting methods for the detection of α‐synuclein aggregates in cerebrospinal fluid (CSF), using a simple 3D printed microscope. Single‐molecule methods enable to probe the early events in the amplification process used in RT‐QuIC and a precise counting of ThT‐positive aggregates. Importantly, the use of single‐molecule counting also allows a refined characterization of the samples and fingerprinting of the protein aggregates present in CSF of patients. The fingerprinting of size and reactivity of individual aggregate shows a unique signature for each PD patients compared to controls and may provide new insights on synucleinopathies in the future.

Longitudinal reproducibility of T1ρ and T2 quantification in a multi-vendor multi-site study

Purpose: Osteoarthritis (OA) is a degenerative joint disease that affects multiple tissues in the joint, presenting with a deterioration of articular cartilage. T2 and T1ρ relaxation times have been shown to be promising biomarkers for early detection of OA due to its sensitivity to cartilage matrix degeneration. However, few studies examined their reliability in a multi-site multi-vendor setting, which is critical for future large-scale trials that use such quantitative measures and for clinical translation of these techniques.

A promising novel biomarker for early-onset preeclampsia: soluble trigger receptor expressed on myeloid cells-1 (sTREM-1)

Background We aimed to explore TREM-1 activation in pregnant women who has preeclampsia through the measurement of its soluble form sTREM. Methods A prospective cohort study was conducted. Participants were recruited from antenatal clinic between 1 May 2019 and 31 August 2019, and they all provided written informed consent for participation. Women between 18 and 42 years of age who were diagnosed with early or late-onset preeclampsia (LOP) were offered participation if they did not have any known systemic disease (chronic hypertension, diabetes, hypothyroidism, chronic renal-liver diseases, etc.); autoimmune disorders; multiple pregnancies; presence of fetal structural and chromosomal anomalies; placenta previa; cholestasis of pregnancy; preterm delivery; evidence of chronic and active infection. The primary outcome of the study was to assess any difference between groups in terms of the diagnostic value of sTREM level. Results A total of 80 patients were enrolled; proven early-onset preeclampsia (EOP) (n = 20), LOP (n = 30), and control (n = 30) groups. There was no significant difference among the groups in terms of age and BMI. Mean gestational age at diagnosis of EOP; 30 ± 1.9 and LOP; 34.7 ± 1.9 weeks gestation. The mean sTREM level was 160.130 ± 1.65 pg/ml in the EOP group, 119.337 ± 2.04 pg/ml in LOP group, and 87.764 ± 1.69 pg/ml in the control group. According to subgroup analysis, sTREM levels were significantly higher in EOP group than control group. Conclusions sTREM might be a promising biomarker for early detection of EOP. However, future studies are necessary to confirm this hypothesis.

Abstract 739: A disintegrin and metalloproteinase 8 as a potential blood biomarker for early diagnosis of gastric cancer

Abstract Purpose: We evaluate the clinical significance of A Disintegrin and Metalloproteinase 8 (ADAM 8) as a potential blood biomarker for gastric cancer (GC). Materials &amp; Methods: Blood ADAM 8 was measured by ELISA and CEA, Cytokines/chemokines (IL-23, SDF-1α/CXCL12, IL-8, and sCD40L) were measured by chemiluminescent immunoassay. They were compared among 5 groups; normal/gastritis, high-risk, early GC (EGC), advanced GC (AGC) without distant metastasis and AGC with distant metastasis by one-way analysis of variance in both training (n=80) and validation dataset (n=241). Clinicopathological features of GC and GC-associated cytokines were evaluated for their correlations with blood ADAM 8. To evaluate the diagnostic accuracy to predict GC, receiver operating characteristic (ROC) curve and logistic regression were used. Results: In both training and validation dataset, blood ADAM 8 increased along the GC carcinogenesis (ANOVA, all of p&amp;lt;0.01). Blood ADAM 8 were significantly higher in EGC and AGC compared with high-risk and normal (post-hoc Bonferroni, all of p&amp;lt;0.01). However, there was no significant difference among cancer groups. Blood ADAM 8 was correlated with N-stage (Spearman's correlation, γs,=0.320, p=0.011), but not correlated with T-stage or M-stage. Pearson's correlations showed blood ADAM 8 was closely correlated with pre-inflammatory cytokines (IL-23, SDF-1α/CXCL12, all of p&amp;lt;0.05), but not correlated with pro-angiogenic cytokines (IL-8, sCD40L). ROC curve and logistic regression demonstrated serum ADAM 8 showed higher diagnostic accuracy (sensitivity, 73.7%; specificity, 86.2%) than CEA (sensitivity, 23.1%; specificity, 91.4%). Combination of ADAM 8 and CEA more increased the diagnostic accuracy to predict GC (sensitivity, 81.8%; specificity, 84.0%). Conclusion: Blood ADAM 8 is a promising biomarker for early detection of GC. Citation Format: Jae-Il Choi, Joon Seong Park, Hye Won Chung, Jong-Baeck Lim. A disintegrin and metalloproteinase 8 as a potential blood biomarker for early diagnosis of gastric cancer [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 739.