Diffuse large B-cell lymphoma (DLBCL), the most common aggressive non-Hodgkin lymphoma, urgently requires novel biomarkers for clinical diagnosis and therapeutic monitoring. Plasma exosomes from three DLBCL patients and three healthy controls were isolated via ultracentrifugation, and differentially expressed circular RNAs (circRNAs) were screened using Arraystar V2 microarrays (fold change FC ≥ 1. 2, P ≤ 0. 05). Candidate circRNAs were validated by quantitative real-time PCR (qRT-PCR) in 55 DLBCL patients and 25 controls. Microarray analysis identified 269 dysregulated circRNAs (152 upregulated, 117 downregulated; FC ≥ 1. 2, P ≤ 0. 05). RT-qPCR confirmed significantly elevated expression of hsacirc₄00230, hsacirc₀01393, and hsacirc₄04447 in DLBCL (P 60 years), stage III/IV, high International Prognostic Index (IPI 3–5), elevated β2-microglobulin (> 2 mg/L), and non-complete remission (Non-CR) status (P < 0. 05). Combined detection with lactate dehydrogenase (LDH) improved predictive efficacy (AUC = 0. 817, P = 0. 002). Post-chemotherapy complete remission (CR) patients exhibited significant reduction in hsacirc₀01393 (P = 0. 0174). Competing endogenous RNA (ceRNA) network analysis identified MLLT3 as a hub gene, with overexpression associated with shorter survival (hazard ratio HR = 2. 31, P = 0. 0042). These findings demonstrate that Plasma exosomal hsacirc₄00230/001393/404, 447 are novel diagnostic biomarkers. hsacirc₀01393 predicts therapeutic resistance and dynamically reflects chemotherapy response, potentially via the hsa-miR-1290/MLLT3 axis. This study advances liquid biopsy strategies for DLBCL management.
Cao et al. (Thu,) studied this question.