The expression and clinical significance of serum exosomal-long non-coding RNA DLEU1 in patients with cervical cancer

Ann Med. 2025 Dec;57(1):2442537. doi: 10.1080/07853890.2024.2442537. Epub 2024 Dec 17.

Abstract

Background: Accumulating evidence has demonstrated that the long non-coding RNA (lncRNA) lymphocytic leukaemia deletion gene 1 (DLEU1) is abnormally overexpressed in many cancer types, including cervical cancer (CC). However, the potential clinical significance of DLEU1 in serum exosomes of patients with CC remains unclear.

Methods: The expression of serum exosomal DLEU1 was detected by quantitative real-time polymerase chain reaction (qRT-PCR). A receiver operating characteristic (ROC) curve was plotted to evaluate the clinical diagnostic efficacy of DLEU1. The Kaplan-Meier survival curve and Cox proportional hazards model were used to assess the effect of DLEU1 on postoperative recurrence, metastasis and prognosis among patients with CC.

Results: Our research showed that DLEU1 expression in the serum exosomes of patients with CC was significantly upregulated compared to that in patients with cervical intraepithelial neoplasia (CIN) and healthy controls (HCs) (both p < .001). DLEU1 relative expression was significantly correlated with tumour size, cervical invasion depth, pathological grade, International Federation of Gynecology and Obstetrics (FIGO) stage and lymph node metastasis among patients with CC (p < .01 all). The combined detection of DLEU1, carbohydrate antigen 125 (CA-125) and squamous cell carcinoma (SCC) exhibited significantly higher diagnostic efficiency (p < .01). Furthermore, the overall survival (OS) and disease-free survival (DFS) of CC patients in the high DLEU1 expression group were markedly lower than those in the low DLEU1 expression group (both p < .01). Cox univariate and multivariate regression analyses indicated that DLEU1 was an independent risk factor for postoperative recurrence and metastasis in CC patients.

Conclusions: Our findings suggest that serum exosome DLEU1 has certain clinical value for diagnosing, monitoring recurrence and metastasis, and evaluating CC prognosis.

Keywords: Cervical cancer; diagnosis; long non-coding RNA; lymphocytic leukaemia deletion gene 1; prognosis.

MeSH terms

  • Adult
  • Biomarkers, Tumor* / blood
  • Biomarkers, Tumor* / genetics
  • Case-Control Studies
  • Clinical Relevance
  • Exosomes* / genetics
  • Exosomes* / metabolism
  • Female
  • Gene Expression Regulation, Neoplastic
  • Humans
  • Kaplan-Meier Estimate
  • Lymphatic Metastasis
  • Middle Aged
  • Neoplasm Recurrence, Local / blood
  • Neoplasm Recurrence, Local / genetics
  • Prognosis
  • Proportional Hazards Models
  • RNA, Long Noncoding* / blood
  • RNA, Long Noncoding* / genetics
  • ROC Curve
  • Up-Regulation
  • Uterine Cervical Dysplasia / blood
  • Uterine Cervical Dysplasia / diagnosis
  • Uterine Cervical Dysplasia / genetics
  • Uterine Cervical Dysplasia / pathology
  • Uterine Cervical Neoplasms* / blood
  • Uterine Cervical Neoplasms* / diagnosis
  • Uterine Cervical Neoplasms* / genetics
  • Uterine Cervical Neoplasms* / pathology

Substances

  • RNA, Long Noncoding
  • Biomarkers, Tumor
  • DLEU1 lncRNA, human

Grants and funding

This work was supported by The Henan Province Medical Science and Technology Research and Development Major Project Jointly Constructed by the Provincial and Ministerial Departments (Grant number: SBGJ202102068; to Q. Xia).