Tumor-Educated Platelets lncRNA-STARD4-AS1 and ELOA-AS1 as Potential Novel Biomarkers for the Early Diagnosis of Non-Small Cell Lung Cancer

ChangLiang Luo, Zhongyuan Lin, Fangfang Huang, Leping Ning, Yulin Yuan Department of Clinical Laboratory, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, 530021, People’s Republic of ChinaCorrespondence: Leping Ning; Yulin Yuan, Department of Clinical Laboratory, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530021, People’s Republic of China, Email ningleping@126.com; yuanyulin@126.comPurpose: (Tumor-educated platelets) TEPs have emerged as active players in all steps of tumorigenesis, confrontation of platelets with tumor cells via transfer of tumor-associated biomolecules and results in the sequestration of such biomolecules. The current study was aimed to examine whether TEPs lncRNA-STARD4-AS1 and ELOA-AS1 might be potential biomarkers for NSCLC.Materials and Methods: TEPs were obtained by low-speed centrifugation. Quantitative real-time PCR was used to determine the expression level of TEPs-STARD4-AS1, ELOA-AS1 in the training cohort and the validation cohort. ROC curve was generated to evaluate their diagnostic value. Correlations between TEPs-STARD4-AS1, ELOA-AS1 and clinical parameters were further analyzed.Results: Our results showed that the level of TEPs-STARD4-AS1 and ELOA-AS1 significantly upregulated in patients with NSCLC compared with healthy controls in the two cohorts. By ROC analysis, we found that TEPs-STARD4-AS1, ELOA-AS1 could offer valuable diagnostic performance for NSCLC patients (AUCSTARD4-AS1 = 0.800/0.774, and AUCELOA-AS1 = 0.754/0.718 for diagnosing adenocarcinoma and squamous cell carcinoma cases from controls, respectively). The combination of TEP-STARD4-AS1 and ELOA-AS1 improved the diagnostic efficiency of NSCLC. Clinicopathological analysis further revealed that TEPs-STARD4-AS1 level significantly correlated with tumor-node-metastasis (TNM) stage (p = 0.011), while TEPs-ELOA-AS1 expression significantly correlated with tumor-node-metastasis (TNM) stage and (p = 0.019) distant metastasis (p = 0.004).Conclusion: Our data suggested that TEPs-STARD4-AS1 and ELOA-AS1 are promising non-invasive circulating diagnostic markers for NSCLC.Keywords: tumor-educated platelets, STARD4-AS1, ELOA-AS1, diagnosis, NSCLC