Abstract
BACKGROUND: Hepatocellular carcinoma (HCC) ranks as the fourth leading cause of cancer-related mortality globally. Studies have confirmed that long non-coding RNAs (lncRNAs) derived from extracellular vesicles (EVs) have great potential in the early diagnosis of HCC. LncRNA nuclear enriched abundant transcript 1 (NEAT1) has been shown to be dysregulated in HCC; however, the expression level of EV-derived NEAT1 remains unclear. This study aims to investigate the expression of EV-derived NEAT1 in HCC and evaluate its diagnostic potential. METHODS: The level of EV-derived lncRNA NEAT1 was compared between 57 HCC patients and 32 controls with benign liver disease to investigate its potential as an HCC biomarkers. The diagnostic performance of the combination of NEAT1 and alpha-fetoprotein (AFP) was evaluated using receiver operating characteristic (ROC) curve analysis. Additionally, the correlation between the expression levels of this biomarker and clinicopathological characteristics was assessed, and its potential value in monitoring disease progression and predicting prognosis in HCC patients was investigated. RESULTS: The expression level of EV-derived lncRNA from HCC patients was significantly upregulated compared to that in controls (P<0.0001). EV-derived NEAT1 demonstrated diagnostic significance for HCC, with an area under the curve (AUC) value of 0.718. The AUC increased to 0.814 when combining NEAT1 and AFP (sensitivity: 73.68%; specificity: 78.12%), which outperformed either biomarker alone. No significant correlations were observed between NEAT1 expression levels and either age or gender, but increased NEAT1 expression was associated with tumor diameter and vascular invasion in HCC patients. CONCLUSIONS: There is a significant difference in the level of EV-derived NEAT1 between HCC patients and benign controls. EV-derived NEAT1 shows potential as a biomarker for HCC diagnosis and may serve as a complement to AFP. The combined use of EV-derived NEAT1 and AFP greatly improves the diagnostic efficiency of HCC.