Comparative evaluation of microRNA detection in plasma, urine and liquid‑based cytology for high‑grade cervical intraepithelial neoplasia

Liquid biopsy offers a minimally invasive approach for cancer diagnosis by detecting circulating biomarkers, such as microRNAs (miRNAs), in different types of specimens. The present study aimed to identify the most effective specimen for miRNA detection in cervical cancer precursor lesions by comparing plasma, urine and liquid-based cytology (LBC). A total of 798 miRNAs were analyzed using NanoString technology in 24 women, equally divided between those with high-grade cervical intraepithelial neoplasia (2/3) and controls with negative Pap and human papillomavirus tests. Comparative analyses revealed that LBC exhibited the highest detection efficiency, with only 1.75% of miRNAs demonstrating low counts, compared with 20.68% in plasma and 15.79% in urine. Additionally, LBC exhibited 21.3% of miRNAs above the 9th decile of expression, compared with 5.89% in plasma and 2.88% in urine. LBC revealed the most consistent detection performance across samples, establishing its potential as the most effective specimen for detecting cervical cancer precursor lesions biomarkers. Plasma also showed promise as a detection medium, whilst urine exhibited higher variability and lower detection consistency. In conclusion, LBC demonstrated the highest efficacy for miRNA detection among the specimen types tested. Plasma remains a viable alternative, whilst urine presents challenges due to its inherent variability. These results underscore the importance of specimen selection for optimizing diagnostic sensitivity in cervical cancer precursor lesions screening.