快速灵敏低成本监测预测乳腺癌疗效

　　外周血液循环的细胞外囊泡蛋白质分子特征分析，可以为晚期乳腺癌诊断、监测、预测提供一种大有希望的无创方法。不过，由于外周血液循环存在对应的可溶性蛋白质，可干扰细胞外囊泡蛋白质分子特征分析。

　　2021年5月5日，英国《自然》旗下《自然通讯》在线发表中国科学院国家纳米科学中心田飞、刘超、孙佳姝、解放军总医院第五医学中心张少华、江泽飞等学者的研究报告，采用一种快速、灵敏、低成本热泳适体传感器，对血浆细胞外囊泡癌症相关蛋白质特征进行分析，而不受可溶性蛋白质干扰，可无创监测和预测晚期乳腺癌的治疗效果。

　　该研究对8种细胞外囊泡蛋白质指标进行加权求和，用于区分36例转移性乳腺癌患者、21例非转移性乳腺癌患者、66例按年龄配对的健康对照者，准确率高达91.1%。

　　对于正在进行治疗的晚期乳腺癌患者，细胞外囊泡蛋白质特征可精准监测训练队列、验证队列、前瞻队列的治疗效果，并且可以作为晚期乳腺癌患者无进展生存的独立预后因素。

　　因此，该研究结果表明，外周血液循环细胞外囊泡蛋白质分析对于晚期乳腺癌管理具有潜在临床实用价值。

Nat Commun. 2021 May 5;12(1):2536.

Protein analysis of extracellular vesicles to monitor and predict therapeutic response in metastatic breast cancer.

Tian F, Zhang S, Liu C, Han Z, Liu Y, Deng J, Li Y, Wu X, Cai L, Qin L, Chen Q, Yuan Y, Liu Y, Cong Y, Ding B, Jiang Z, Sun J.

CAS Center for Excellence in Nanoscience, National Center for Nanoscience and Technology, Beijing, China; School of Future Technology, University of Chinese Academy of Sciences, Beijing, China; The Fifth Medical Centre, Chinese PLA General Hospital, Beijing, China; The Second Medical Center, Chinese PLA General Hospital, Beijing, China.

Molecular profiling of circulating extracellular vesicles (EVs) provides a promising noninvasive means to diagnose, monitor, and predict the course of metastatic breast cancer (MBC). However, the analysis of EV protein markers has been confounded by the presence of soluble protein counterparts in peripheral blood. Here we use a rapid, sensitive, and low-cost thermophoretic aptasensor (TAS) to profile cancer-associated protein profiles of plasma EVs without the interference of soluble proteins. We show that the EV signature (a weighted sum of eight EV protein markers) has a high accuracy (91.1 %) for discrimination of MBC, non-metastatic breast cancer (NMBC), and healthy donors (HD). For MBC patients undergoing therapies, the EV signature can accurately monitor the treatment response across the training, validation, and prospective cohorts, and serve as an independent prognostic factor for progression free survival in MBC patients. Together, this work highlights the potential clinical utility of EVs in management of MBC.

PMID: 33953198

DOI: 10.1038/s41467-021-22913-7