Exosomal Del-1 as a Potent Diagnostic Marker for Breast Cancer: Prospective Cohort Study

• DOI: 10.1016/j.clbc.2021.02.002
• Publication Date: 2021-02-18T05:38:59Z
• Authors: Soo Jung Lee; Jeeyeon Lee; Jin Hyang Jung; Ho Yong Park; Pyong-Gon Moon; Yee Soo Chae; Moon-Chang Baek
• Keywords: Adult; 0303 health sciences; Calcium-Binding Proteins; Breast Neoplasms; Enzyme-Linked Immunosorbent Assay; Middle Aged; Prognosis; 3. Good health; 03 medical and health sciences; Risk Factors; Biomarkers, Tumor; Humans; Female; Prospective Studies; Neoplasm Grading; Cell Adhesion Molecules; Neoplasm Staging

The differential diagnostic role of plasma developmental endothelial locus-1 (Del-1) was proposed in our previous study. Therefore the current study aimed to confirm the diagnostic role and explore the prognostic role of exosomal Del-1 in a prospective cohort of female patients with breast cancer.To determine the optimal sampling time for the postoperative Del-1 measurements, blood was serially collected on days 1, 3, 5, and 7 after surgery in 22 patients (cohort 1). Thereafter, 111 female patients with breast cancer were prospectively enrolled (cohort 2) to compare exosomal Del-1 levels before and after surgery.Among the subsequent prospective cohort, 107 patients (96.4%) showed a high exosomal Del-1 level (optical density [OD] value > 0.5) at the time of diagnosis. Of these patients, 101 (94.6%) in this high-level group showed normalized Del-1 levels postoperatively, representing a significant difference (mean OD value, 1.232 vs. 0.196; P < .00001). High postoperative Del-1 level was significantly associated with a worse disease-free survival adjusted to the clinicopathological characteristics (hazard ratio, 24.0; P = .0011).This study confirmed the normalization of exosomal Del-1 after surgery, indicating exosomal Del-1 as a potent diagnostic biomarker for breast cancer. In addition, because a high Del-1 level after surgery was associated with early relapse, this suggests exosomal Del-1 as a potential prognostic marker by identifying the existence of residual cancer.