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However, the significance of circulating exosomal ncRNAs in the prognosis of hepatocellular carcinoma (HCC) remains to be elucidated. We therefore determined the prognostic significance of circulating exosomal ncRNAs (miRNA\u201021 and lncRNA\u2010ATB) for human HCC. This prospective study enrolled 79 HCC patients between October 2014 and September 2015. Exosomes were extracted from serum samples using the ExoQuick Exosome Precipitation Solution. To validate the isolation of the exosomes from serum, immunoblotting for exosome markers and characterization of nanoparticle using NanoSight were performed. NcRNAs were isolated from exosomes using the miRNeasy serum\/plasma micro kit. Both circulating exosomal miRNA\u201021 and lncRNA\u2010ATB were related to TNM stage and other prognostic factors, including the T stage and portal vein thrombosis. Multivariate analysis using the Cox regression test identified that both higher miRNA\u201021 and higher lncRNA\u2010ATB were independent predictors of mortality and disease progression, along with larger tumor size and higher C\u2010reactive protein (all <jats:italic>p<\/jats:italic> &lt; 0.05). The overall survival and progression\u2010free survival were significantly lower in patients with higher circulating levels of exosomal miRNA\u201021 (\u22650.09) and lncRNA\u2010ATB (\u22650.0016) (log\u2010rank test: <jats:italic>p<\/jats:italic> &lt; 0.05). In conclusion, our study has provided strong evidence that circulating exosomal ncRNAs (miRNA\u201021 and lncRNA\u2010ATB) are novel prognostic markers and therapeutic targets for HCC.<\/jats:p>","DOI":"10.1002\/ijc.31931","type":"journal-article","created":{"date-parts":[[2018,10,19]],"date-time":"2018-10-19T12:04:48Z","timestamp":1539950688000},"page":"1444-1452","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":225,"title":["Circulating exosomal noncoding RNAs as prognostic biomarkers in human hepatocellular carcinoma"],"prefix":"10.1002","volume":"144","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1916-1448","authenticated-orcid":false,"given":"Yu Rim","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Internal Medicine School of Medicine, Kyungpook National University, Kyungpook National University Hospital  Daegu South 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