Roberto Parisi

Conference 2023 Presentation

 

Project title

Analysis of exosomal miRNAs in liquid biopsies as a potential diagnostic and prognostic tool for thyroid cancer: a review and future perspectives

 

Authors and Affiliations

Roberto Parisi1

1. Department of Medicine and Surgery, Università degli Studi di Salerno, Salerno, Italy

 

Abstract

Background

Liquid biopsy represents a potential diagnostic and prognostic tool in clinical oncology thanks to the analysis of several biomarkers, extracted from a peripheral blood sample, to diagnose and prognose different types of human cancer. Among the quantifiable plasma components, exosomes carry several elements, including miRNAs which might be able to regulate the tumour microenvironment (TME). Thyroid cancer represents one of the most common endocrine malignancies worldwide and its classification depends on histopathological features and eventual gene alterations (e.g, BRAF, RAS, PTEN, ALK mutations or PAX8/PPARG and RET/PTC translocations). Therefore, the extraction and purification of exosomal miRNAs with liquid biopsies might supply the specific genetic material to infer a diagnostic and prognostic evaluation of thyroid cancer.

Methods

An extensive literature review has been conducted to define a panel of candidate exosomal miRNAs, focusing on several original studies that correlated miRNA expression levels with clinicopathological cancer features. A cluster of miRNAs was then selected, based on the statistical significance of the study results, and its clinical importance was analysed and discussed through different current clinical tools (e.g., thyroid function tests, US, FNA, etc…).

Results

Based on the systematic literature review, several exosomal miRNAs show a significant dysregulation in expression levels. For example, miR-146a-5p downregulation was correlated with the presence of papillary thyroid cancer (PTC) in several studies. In addition, miR-222 upregulation seems to be associated with distant metastases and poor clinical outcome in PTC patients, making it a potential biomarker for the early risk stratification in clinical routine, while miR-376-a upregulation seems to be prevalent in less aggressive PTC phenotypes.

Conclusions

Exosomal miRNAs might be integrated, as next-generation sequencing (NGS) panels, in future liquid biopsies to early diagnose and prognose thyroid cancer, leading to the development of novel strategies for screening and therapy. With the literature review, it has also been possible to state that a considerable portion of the selected exosomal miRNAs seems to influence different angiogenic pathways in the tumour microenvironment and more research might be needed to unravel the relationship between the invasive and metastatic potential of thyroid cancer and the expression levels of pro-angiogenic miRNAs.