Serum Insights: Leveraging the Power of miRNA Profiling as an Early Diagnostic Tool for Non-Small Cell Lung Cancer

Simple Summary Non-small cell lung cancer (NSCLC) is a prevalent and lethal disease. Circulating cell-free miRNA has the potential to serve as a biomarker for early detection as it reflects cancer characteristics. Through global miRNA profiling in serum samples from NSCLC patients and non-cancerous individuals, we identified 28 upregulated miRNAs in NSCLC and explored their relevance to NSCLC-related pathways. Harnessing an advanced machine-learning algorithm, we successfully developed a robust classifier capable of distinguishing NSCLC from non-cancerous cases. Our findings suggest that serum miRNAs hold promise as a valuable tool for early NSCLC diagnosis and offer valuable insights into NSCLC biology. To solidify these promising results, further validation in diverse patient cohorts is essential.Abstract Non-small cell lung cancer is the predominant form of lung cancer and is associated with a poor prognosis. MiRNAs implicated in cancer initiation and progression can be easily detected in liquid biopsy samples and have the potential to serve as non-invasive biomarkers. In this study, we employed next-generation sequencing to globally profile miRNAs in serum samples from 71 early-stage NSCLC patients and 47 non-cancerous pulmonary condition patients. Preliminary analysis of differentially expressed miRNAs revealed 28 upregulated miRNAs in NSCLC compared to the control group. Functional enrichment analyses unveiled their involvement in NSCLC signaling pathways. Subsequently, we developed a gradient-boosting decision tree classifier based on 2588 miRNAs, which demonstrated high accuracy (0.837), sensitivity (0.806), and specificity (0.859) in effectively distinguishing NSCLC from non-cancerous individuals. Shapley Additive exPlanations analysis improved the model metrics by identifying the top 15 miRNAs with the strongest discriminatory value, yielding an AUC of 0.96 +/- 0.04, accuracy of 0.896, sensitivity of 0.884, and specificity of 0.903. Our study establishes the potential utility of a non-invasive serum miRNA signature as a supportive tool for early detection of NSCLC while also shedding light on dysregulated miRNAs in NSCLC biology. For enhanced credibility and understanding, further validation in an independent cohort of patients is warranted.