title: Five microRNAs in plasma as novel biomarkers for screening of early-stage non-small cell lung cancer.
abstract: BACKGROUND
  In order to find novel noninvasive biomarkers with high accuracy for the screening of early-stage non-small cell lung cancer (NSCLC), we investigate the predictive power of 5 microRNAs (miR-20a, miR-145, miR-21, miR223 and miR-221) as potential biomarkers in early-stage NSCLC.
  
  
  METHODS
  In training set, 25 early-stage NSCLC patients and 25 matched healthy controls are included to assess the miRNA expression profile between early-stage NSCLC patients and healthy controls by real-time RT-PCR. We found that five of these miRNAs (miR-20a, miR-223, miR-21, miR-221 and miR-145) levels in NSCLC patients were significantly dysregulated compared with the healthy groups and thus were selected to validation set. Therefore, a validation experiment was further performed to investigate the potential predictive power of these five miRNAs based on 126 early-stage NSCLC patients, 42 NCPD patients and 60 healthy controls. The receiver operating characteristic (ROC) curves were generated for the five miRNAs.
  
  
  RESULTS
  ROC curve analyses suggested that these five plasma miRNAs could be promising biomarkers for NSCLC, with relatively high AUC values as follows: miR-20a, 0.89 with 95% CI of [0.85-0.93]; miR-223, 0.94 with 95% CI of [0.91-0.96]; miR-21, 0.77 with 95% CI of [0.71-0.83]; miR-155, 0.92 with 95% CI of [0.89-0.96]; miR-145, 0.77 with 95% CI of [0.71-0.83]. Stratified analyses indicated that plasma miR-20a, miR-223, miR-21 and miR-145 showed better predictive value in smokers than in non-smokers, while miR-155 might be more suitable for non-smokers. In addition, all of these five miRNAs could differentiate NSCLC from controls with a higher accuracy in advanced stage and squamous carcinoma subgroups.
  
  
  CONCLUSIONS
  In conclusion, our study suggested that five plasma miRNAs (miR-20a, miR-145, miR-21, miR-223 and miR-221) can be used as promising biomarkers in early screening of NSCLC. Nevertheless, further validation and optimizing improvement should be performed on larger sample to confirm our results.
authors.affiliation: Department of Thoracic Surgery, Renmin Hospital of Wuhan University, 238 Jie Fang Rd, Wuhan, 430060, China. qinggeng@med-research.biz.
authors.forename: Qing
authors.initials: Q
authors.lastname: Geng
authors.affiliation: Department of Thoracic Surgery, Renmin Hospital of Wuhan University, 238 Jie Fang Rd, Wuhan, 430060, China. fan_taooo@163.com.
authors.forename: Tao
authors.initials: T
authors.lastname: Fan
authors.affiliation: Department of Thoracic Surgery, Renmin Hospital of Wuhan University, 238 Jie Fang Rd, Wuhan, 430060, China. zh_boyou@yeah.net.
authors.forename: Boyou
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Thoracic Surgery, Renmin Hospital of Wuhan University, 238 Jie Fang Rd, Wuhan, 430060, China. wwangei_77@126.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Thoracic Surgery, Renmin Hospital of Wuhan University, 238 Jie Fang Rd, Wuhan, 430060, China. xyxy_mn@163.com.
authors.forename: Yao
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Thoracic Surgery, Renmin Hospital of Wuhan University, 238 Jie Fang Rd, Wuhan, 430060, China. haoo_hu@yeah.net.
authors.forename: Hao
authors.initials: H
authors.lastname: Hu
mesh_terms: D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000097:blood / Q000235:genetics*; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood / Q000235:genetics* / Q000473:pathology; D016022:Case-Control Studies; D004311:Double-Blind Method; D005260:Female; D020869:Gene Expression Profiling / Q000379:methods*; D005820:Genetic Testing / Q000379:methods*; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000235:genetics* / Q000473:pathology; D008297:Male; D035683:MicroRNAs / Q000097:blood / Q000235:genetics*; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012307:Risk Factors
chemical_list: D014408:Biomarkers, Tumor; D035683:MicroRNAs