The most common cancer-related fatality is non-small cell lung cancer (NSCLC). A successful pulmonary resection is possible in 20% of cases when detected early, although many patients still have illness recurrence. Patients with a higher risk of recurrence may be identified by biomarkers, which might be extremely helpful. Extracellular vesicles (EV)-free and EV-encapsulated circulating microRNAs (miRNAs) are interesting indicators in this context.

For a prospective observational cohort analysis, the researchers examined individuals with early-stage (IA-IIIA) NSCLC who were operated on at 3 separate facilities (IRST-IRCCS, VHIO, and CHU de Strasburg). The primary outcome was a recurrence within two years of the operation. Each patient had peripheral blood drawn to obtain plasma later on. Plasma was collected to get circulating free and EV-derived miRNAs. The Illumina NextSeq 550 and the QIAseq miRNA Library Kit created miRNA-specific libraries. Using the edgeR R statistical software program, data were normalized and examined for differential expression. It was normalized using the TMM approach. Multiple testing was corrected for using the Benjamini-Hochberg method.

There were 220 patients enrolled in total. Age range: 43.6 to 84.7 years, with 68.5 being the median. Stage IA cancers were found in 99 (46.5%) individuals, stage IB tumors in 38 (17.8%), stage IIA tumors in 27, stage IIB tumors in 40 (18.8%), and stage IIIA tumors in 9. About 42 (19%) had squamous cell carcinoma, 168 (76%) had adenocarcinoma histology, and 12 (5%) had various tumor histotypes. Recurrence rates for stages IA, IB, IIA, IIB, and IIIA were 10.5%, 16.7%, 11.1%, 38.5%, and 48.6%, respectively. The total relapse rate was 25%. Overall, relapsed patients had a distinct expression pattern from non-relapsed patients for 16 and 7 EV and EV-free miRNAs, respectively. In both EV-free and relapsed patient comparisons, 4 miRNAs (hsa-miR-182-5p, hsa-miR-183-5p, hsa-miR-1246, and hsa-miR-196b-5p) had substantially higher levels of expression.

According to the early investigation, patients who are more likely to experience a recurrence after surgery can be identified using both free and EV-derived miRNAs.