脑动脉瘤破裂出血一例误诊分析

1 病例资料 男,46岁.因突发性头痛5d入院.5d前体力劳动时突然出现剧烈头痛,呈持续性,伴恶心,无呕吐,意识清楚,言语正常,视物略模糊,无肢体麻木及肌力减弱.遂就诊于当地卫生院,按"上呼吸道感染"予静脉输液,头痛略减轻,但余症状、体征未见好转,遂转往某驻军医院,行头颅CT检查示:第三脑室前方脑出血破入右侧脑室前角,蛛网膜下腔出血.以"脑出血"收入院.     

示教片、有奖测验(2)

CT号:0078,MRI号:10728 女性,49岁。头晕头痛一年,右侧听觉下降伴行走不稳2月。体检:一般情况好,体温正常,右侧听力明显减退,左侧正常。 CT表现:头颅CT平扫,骨窗和脑窗示右后颅窝巨大肿块,呈等、低混杂密度,无明确脂肪密度影和钙化灶,肿块侵入右枕骨内板和板障,形成局部骨质缺损。MRI表现:头颅平扫和增强扫描,肿块信号不均,T_1WI以稍低信号为主,内有散在的灶性高信号,T_2WI呈明显高信号,信号不均;肿块内呈T1WI稍高信号、T2WI稍低信号的部分呈星芒状政变,增强后肿块无强化。右小脑半球受压移位。     

无瘫痪非典型脑出血的早期诊断

目的 探讨非典型脑出血的早期诊断.方法 对无任何瘫痪表现的脑出血病例的临床资料作回顾性分析.结果 对年龄较大的或有高血压病史者当出现头痛、恶心、呕吐、头晕等症状,而未能及时行头颅CT检查,导致误诊者是主要原因.结论 提高对非典型脑出血的认识和重视,对年龄在50岁以上或原有高血压病史突然出现头痛、头晕、恶心、呕吐等症状而无瘫痪者应常规进行CT检查,可达早期诊断的目的.     

恶化性脑出血95例临床与CT动态观察

急性脑血管病(包括出血性和缺血性)在发病后几天至1个月内临床症状呈进行性加重者称为恶化性卒中,我院自1992年8月～1996年12月共收治脑出血340例,其中153例表现为恶化性脑出血,我们对其中95例,根据临床进行了CT动态观察,现进行分析报道。 1 临床资料 1.1 一般资料:男69例,女26例。年龄32～83岁,平均65岁,其中<40岁5例,40～49岁11例,50～59岁36例,60～69岁28岁,>70岁15例。 1.2 恶化性脑出血的诊断依据:急性发病、一侧肢体瘫痪、头痛、呕吐,发病时意识清楚或模糊,除血压外其它生命体征平稳,发病当天均经头颅CT     

脑脊液置换术治疗脑出血破入脑室的效果观察

探讨脑脊液置换术治疗脑出血破入脑室的临床效果。从诊治的脑出血破入脑室患者中抽取58例作为研究对象,并根据不同治疗方式分为对照组和治疗组各29例,对照组应用常规综合治疗方法,治疗组在对照组基础上加用脑脊液置换术,对比两组治疗2周后头颅CT血液吸收100%率及临床症状缓解时间。结果:(1)治疗组CT血液吸收100%率为75.86%,高于对照组的48.28%(P0.05);(2)治疗组头痛、呕吐缓解时间均短于对照组(P均0.01)。脑脊液置换术治疗脑出血破入脑室的临床效果确切,可有效提升其头颅CT血液吸收100%率,并快速缓解呕吐、头痛症状,值得借鉴。     

脑肿瘤出血的临床特点及手术治疗探讨

目的:探讨脑肿瘤出血的临床特点及手术治疗方法.方法:回顾性分析2007年6月~2011年6月兴宁市人民医院急诊收治的脑肿瘤出血患者23例的临床资料.结果:脑肿瘤出血的症状主要有突发剧烈的头痛、呕吐、偏瘫或者偏瘫加重、失语和意识障碍;8例患者头颅CT平扫见颅内低密度肿瘤征象与均匀高密度出血影并存,15例经头颅增强CT扫描确诊.21例患者通过手术治疗、切除肿瘤、清除血块,16例患者临床治愈出院,有4例患者好转出院,有1例患者术后病情恶化死亡.结论:脑肿瘤出血多以急性起病为表现,易误诊为脑出血,头颅增强CT扫描有助于明确诊断,确诊后应进行手术治疗,尽早切除肿瘤,清除血块.     

高血压脑出血误治致迟发性脑水肿12例分析

我院1999~2006年收治脑出血发生迟发性脑水肿的12例,分析如下。1临床资料1.1一般资料本组男7例,女5例,年龄52~70岁。均有明确高血压病史,表现头痛、呕吐、肢体无力、头颅CT示脑出血,符合高血压脑出血诊断标准[1]。出血量在30~60 ml。其中脑叶出血2例,基底节出血8例,丘脑出血2例。均于发病2周后出症状突然加重,9例出现昏迷,2例肢体瘫痪加重,1例头痛加重,复查CT均排除再出血,均表现为水肿体积加大,中线结构移位。1.2应用脱水药情况本组中有5例在治疗2周时将甘露醇减量每日125 ml。1例在第2周一次将甘油果糖、速尿、白蛋白全部停用。3例每8 h…     

脑脊液白细胞增多为主的脑出血3例

脑出血患者约有20%其脑脊液(CSF)呈清亮、非血性,少数CSF可单纯表现为白细胞增多或以白细胞增多为主。我科在经电子计算机X线断层扫描(CT)证实为脑出血的48例患者中同时检查CSF发现3例(6.3%),现报告如下。病例报告例1:男,73岁。1天前晨起出现头痛,并感     

脑转移性恶性黑色素瘤误诊1例

患者女，63岁。因头晕、头痛5天，昏睡20小时入院。否认头部外伤史。查体：血压17／9kPa，嗜睡状，左侧肢体肌力4度。头颅CT表现为：右额高密度阴影，约6cm×5cm×4cm，中线左移。诊断：脑血管畸形（AVM）并右额叶脑出血。于1995年1月23日在全麻下行右额开颅，脑内血肿清除术，术中未见畸形血管团。术后13天出院。约11日再次出现头痛、频繁呕吐。复查头颅CT见右额高密度阴影。于1995年3月13日再拟AVM术后再出血在全麻下行右额开颅，血肿清除术。术后半个月复查头颅CT示：手术区脑组织呈低密度改变，约4cm×4cm×3cm，考虑为术后脑水肿…     

以精神运动性癫持续状态为突出表现的双侧颞叶出血1例

1典型病例患者,男,75岁,因突发精神、行为异常4 h入院。既往无高血压病史。于4 h前与人打麻将时突然出现,表现为情绪激动、焦虑不安、言语错乱、答非所问、记忆及定向障碍,反复说“这是干什么?”,其余体格检查及治疗极不合作,无明显头痛、呕吐、抽搐、偏瘫、昏迷、共济失调及二便失禁等。肌注安定仍不配合体检,经强制静脉滴注冬非合剂后逐渐入睡,血压正常,未引出病理征。头颅螺旋CT示:双侧颞叶出血。按脑出血治疗,并予氯丙嗪等对症维持,治疗期间,情绪稍平稳,但感觉性失语,记忆及定向障碍持续。治疗4周后,复查头颅螺旋CT示:双侧颞叶出血基…     

内科胸腔镜下胸腔内清理治疗非结核性脓胸的临床研究

目的观察分析胸腔镜下胸腔内清理治疗非结核性脓胸的临床疗效。方法选取2015年1月-2017年6月于该院就诊的非结核性脓胸患者48例,根据治疗方式,分为观察组(n=24)与对照组(n=24),观察组患者给予胸腔镜下胸腔内清理治疗,对照组患者给予传统开胸术治疗,对比两组患者的治疗效果。结果观察组患者的手术时间、术中出血量、引流时间、住院时间均明显少于对照组(P0.05);治疗前,两组患者的用力肺活量(FVC)、第一秒用力肺活量(FEV1)、肺总量(TLC)对比差异无统计学意义(P0.05);治疗后,两组患者的FVC、FEV1、TLC均明显增加(P0.05),且观察组患者的FVC、FEV1、TLC明显高于对照组(P0.05)。两组患者治疗后氧分压(PO_2)、二氧化碳分压(PCO_2)及白细胞计数(WBC)明显优于治疗前,且观察组治疗后患者PO_2(80.30±9.26)mm Hg、PCO_2(45.53±4.27)mm Hg及WBC(8.85±3.62)g/L指标明显优于对照组的PO_2(70.33±8.75)mm Hg、PCO_2(51.61±5.40)mm Hg及WBC(10.81±4.00)g/L,差异有统计学意义(P0.05)。结论胸腔镜辅助下行胸腔内清理治疗非结核性脓胸的创伤小,术后患者恢复快。     

腹腔镜与开腹Bismuth-Ⅰ型肝门胆管癌根治术的疗效分析*

目的探讨腹腔镜与开腹行Bismuth-Ⅰ肝门胆管癌根治术的的临床效果。方法回顾分析2011年1月-2017年1月在该院行开腹(24例)及腹腔镜(10例)手术治疗的34例Bismuth-Ⅰ型肝门胆管癌患者的临床资料。结果两组患者均成功行Bismuth-Ⅰ型肝门胆管癌根治术,腹腔镜组患者平均术中出血量(179.50±98.05)ml和术后平均住院时间(11.80±2.49)d,明显低于开腹组的(261.25±97.33)ml和(16.25±3.35)d,差异有统计学意义(P0.05)。腹腔镜组术后第1、3和5天的总胆红素(TBIL)分别为(102.20±45.49)、(83.57±30.66)和(45.09±18.41)mmol/L;开腹组术后第1、3和5天TBIL分别为(148.17±62.78)、(121.60±43.35)和(80.59±43.89)mmol/L,两组差异有统计学意义(P0.05)。且腹腔镜组术后淋巴结检出数(9.79±3.05)枚、术后并发症1例、切缘阳性数0例;开腹组术后淋巴结检出数(9.30±3.06)枚,术后并发症3例,切缘阳性数0例,两组差异无统计学意义(P0.05)。两组患者均获得6~18个月的随访,在随访期间两组患者均未见复发及转移。结论腹腔镜下Bismuth-Ⅰ型肝门胆管癌根治术在淋巴结清扫、术后并发症、切缘阳性率和随访期间预后等方面与开腹Bismuth-Ⅰ型肝门胆管癌根治术效果相似,且更具微创优势。因此,腹腔镜下Bismuth-Ⅰ型肝门胆管癌根治术是安全、可行的手术方式。     

腹腔镜及开腹手术在直肠癌患者临床治疗中的效果对比

目的对比腹腔镜及开腹手术在直肠癌患者临床治疗中的效果。方法选取该院胃肠肿瘤外科2008年5月-2013年5月收治的直肠癌患者80例,随机将这些患者分为腹腔镜手术组(n=40)和开腹手术组(n=40)两组,对两组患者的手术时间、术中出血量、切口长度、淋巴结清扫数量、首次通气时间、下床活动时间、住院时间、住院费用、术后并发症发生情况和治疗满意度进行统计分析。结果腹腔镜手术组患者的手术时间明显长于开腹手术组(P0.05),术中出血量明显少于开腹手术组(P0.05),切口长度明显短于开腹手术组(P0.05),首次通气时间、下床活动时间、住院时间均明显短于开腹手术组(P0.05),住院费用明显高于开腹手术组(P0.05),术后并发症发生率15.0%(6/40)明显低于开腹手术组35.0%(14/40)(P0.05),治疗满意度97.5%(39/40)明显高于开腹手术组67.5%(27/40)(P0.05)。结论腹腔镜手术在直肠癌患者临床治疗中的效果较开腹好。     

比较PET/CT显像中肝脏18F-FDG摄取半定量分析方法

目的 探讨PET/CT显像中影响肝脏¹⁸F-FDG摄取的因素,分析常规体质量（BM）、瘦体质量（LBM）及体表面积（BSA）校正最大标准化摄取值（SUV_max-B、SUV_max-L、SUV_max-S）的应用价值。方法 回顾性分析行¹⁸F-FDG PET/CT显像的67名健康受检者。测量肝脏SUV_max-B、SUV_max-L及SUV_max-S,分析年龄、空腹血糖水平、体质量指数（BMI）、肝脏CT值、性别、脂肪肝对上述参数的影响。结果 空腹血糖水平与肝脏SUV_max-B、SUV_max-L、SUV_max-S均呈正相关（r=0.329、0.336、0.353,P=0.012、0.010、0.007）。BMI与肝脏SUV_max-B （r=0.543,P<0.01）、SUV_max-L （r=0.328,P=0.07）呈正相关BMI与SUV_max-S无相关性（r=0.026,P=0.833）。受检者年龄、肝脏CT值与肝脏SUV_max-B、SUV_max-L、SUV_max-S均无相关性（P均>0.05）。男性肝脏SUV_max-B （t=2.608,P=0.011）、SUV_max-L （t=5.272,P<0.001）明显高于女性,男性与女性肝脏SUV_max-S无统计学差异（t=0.759,P=0.450）。脂肪肝受检者与非脂肪肝受检者肝脏SUV_max-B、SUV_max-L、SUV_max-S均无统计学差异（P=0.646、0.775、0.068）。结论 空腹血糖水平、BMI、性别是PET/CT显像中影响肝脏摄取¹⁸F-FDG的因素。BMI较大的受检者可采用SUV_max-L或SUV_max-S代替SUV_max-B,此外SUV_max-S可弥补性别间的差异,但校正技术无法减弱血糖水平对肝脏SUV_max的影响。     

Transfusion of erythrocyte concentrates produces a variable increment on cerebral oxygenation in patients with severe traumatic brain injury

Objective To investigate the long-term influence of erythrocyte transfusion on cerebral oxygenation in patients with severe traumatic brain injury.Design Prospective and observational study.Setting Neurotrauma intensive care unit of trauma center level I.Patients Sixty consecutive, hemodynamically stable patients with severe traumatic brain injury, pretransfusion hemoglobin < 100 g/l, non-bleeding and monitored through intracranial pressure and brain tissue partial pressure of oxygen (PtiO₂) catheters were included.Interventions Transfusion of 1–2 units of red blood cells.Measurements and results Ten sets of variables (pretransfusion, end of transfusion, and 1, 2, 3, 4, 5, 6, 12 and 24 h after transfusion) were recorded, including: PtiO₂, cerebral perfusion pressure (CPP), end-tidal CO₂, peripheral saturation of oxygen, temperature, hemoglobin, lactate and PaO₂/FiO₂ ratio. Transfusion was associated with an increase in PtiO₂ during a 6-h period, with a peak at 3 h (26.2%; p = 0.0001) in 78.3% of the patients. No relationship was observed between PtiO₂, CPP and hemoglobin increments. The relative increment in PtiO₂ at hour 3 was only correlated with baseline PtiO₂ (r² 0.166; p = 0.001). All of the patients with basal PtiO₂ < 15 mmHg showed an increment in PtiO₂ versus 74.5% of patients with basal PtiO₂ ≥ 15 mmHg (p < 0.01, hour 3).Conclusions Erythrocyte transfusion is associated with a variable and prolonged increment of cerebral tissue oxygenation in anemic patients with severe traumatic brain injury. Low baseline PtiO₂ levels (< 15 mmHg) could define those patients who benefit the most from erythrocyte transfusion.     

内镜下治疗大肠息肉并发出血的危险因素以及腺瘤性息肉的癌变特征分析

目的该研究目的是认识直径≥1.0 cm大肠息肉临床特点、内镜下治疗出血的危险因素及腺瘤性息肉癌变的特征分析。方法回顾该院2014年1月1日-2016年1月1日经内镜下切除的直径≥1.0 cm大肠息肉741例患者,共884枚息肉;分析患者的临床资料、内镜下特点、息肉切除出血危险因素及腺瘤性息肉癌变的特征。结果大肠息肉内镜下切除术术中、迟发性出血的单因素分析中,发现性别(P=0.017)、息肉部位(P=0.011)、息肉大小(P=0.004)、表面是否分叶(P=0.010)、内镜手术方式(P=0.029)在两组间差异有统计学意义;以息肉为观察单位,对患者临床资料和内镜下特点进行Logistic回归多因素分析时,发现性别(P=0.012,OR=2.671,95%CI=1.246~5.728)为独立危险因素,男性比女性更易发生出血;息肉部位为乙状结肠相对于直肠来讲为保护因素(P=0.011,OR=0.348,95%CI=0.154~0.786),息肉大小≥3.0 cm相对于息肉大小为1.0~1.9 cm来讲为危险因素(P=0.049,OR=2.530,95%CI=1.005~6.374)。大肠腺瘤性息肉癌变特征单因素分析时,发现表面是否分叶(P=0.001)、是否光滑(P=0.017)、山田分型(P=0.008)在两组间差异有统计学意义,进行Logistic回归分析多因素时,得出表面分叶(P=0.001,OR=6.556,95%CI=2.326~18.475)是腺瘤性息肉癌变的独立危险因素。结论内镜下治疗大肠息肉是一种安全的治疗方法 ;以息肉为观察单位,性别为大肠息肉内镜下切除术术中、迟发性出血的独立危险因素,男性比女性更易发生出血;息肉直径越大,发生出血的可能性越大;表面分叶的大肠腺瘤性息肉提示癌变的可能性大。     

In vitro antifungal activity of luliconazole against clinical isolates from patients with dermatomycoses

The in vitro antifungal activity of luliconazole, a novel topical imidazole, against pathogenic fungi implicated in dermatomycoses was studied. A total of 91 clinical isolates, consisting of 59 Trichophyton rubrum isolates, 26 T. mentagrophytes isolates, 1 Epidermophyton floccosum isolate, and 5 Candida albicans isolates were tested by the broth microdilution method, employing lanoconazole, terbinafine, and bifonazole as reference drugs. The minimum inhibitory concentrations (MICs) of luliconazole against T. rubrum and T. mentagrophytes were in the range of 0.00012–0.004 μg/ml and 0.00024–0.002 μg/ml, respectively. The MIC₉₀ of luliconazole for these two species of dermatophytes was the same, at 0.001 μg/ml, and these values were 4 times, 30 times, and more than 1000 times lower than those of lanoconazole, terbinafine, and bifonazole, respectively. Similarly, the 1 isolate of E. floccosum tested was inhibited by luliconazole with an MIC of 0.001 μg/ml. Luliconazole also proved to be very potent against C. albicans (MIC range, 0.031–0.25 μg/ml), nearly on par, in terms of efficacy, with lanoconazole (0.063–0.25 μg/ml) and more potent than terbinafine (2–>64 μg/ml) and bifonazole (0.5–4 μg/ml). These results showed that luliconazole was very potent in vitro against pathogenic fungi isolated from patients with dermatomycoses, and these findings emphasized the utility of luliconazole for the topical management of this condition.     

Short-term improvement in insomnia symptoms predicts long-term improvements in sleep,pain, and fatigue in older adults with comorbid osteoarthritis and insomnia

In a primary care population of 367 older adults (aged ?60 years) with osteoarthritis (OA) pain and insomnia, we examined the relationship between short-term improvement in sleep and long-term sleep, pain, and fatigue outcomes through secondary analyses of randomized controlled trial data. Study participants, regardless of experimental treatment received, were classified either as improvers (?30% baseline to 2-month reduction on the Insomnia Severity Index [ISI]) or as nonimprovers. After controlling for treatment arm and potential confounders, improvers showed significant, sustained improvements across 18 months compared with nonimprovers in pain severity (P < 0.001, adjusted mean difference = −0.51 [95% CI: −0.80, −0.21), arthritis symptoms (P < 0.001, 0.63 [0.26, 1.00]), and fear avoidance (P = 0.009, −2.27 [−3.95, −0.58]) but not in catastrophizing or depression. Improvers also showed significant, sustained improvements in ISI (P < 0.001, −3.03 [−3.74, −2.32]), Pittsburgh Sleep Quality Index Total (P < 0.001, −1.45 [−1.97, −0.93]) and general sleep quality (P < 0.001, −0.28 [−0.39, −0.16]) scores, Flinders Fatigue Scale (P < 0.001, −1.99 [−3.01, −0.98]), and Dysfunctional Beliefs About Sleep Scale (P = 0.037, −2.44 [−4.74, −0.15]), but no improvements on the Functional Outcomes of Sleep Questionnaire or the Epworth Sleepiness Scale. We conclude that short-term (2-month) improvements in sleep predicted long-term (9- and 18-month) improvements for multiple measures of sleep, chronic pain, and fatigue. These improvements were not attributable to nonspecific benefits for psychological well-being, such as reduced depression. These findings are consistent with benefits of improved sleep for chronic pain and fatigue among older persons with osteoarthritis pain and comorbid insomnia if robust improvements in sleep are achieved and sustained. Trial Registration: ClinicalTrials.gov Identifier: NCT01142349.     

InterMiG: international differences in the therapeutic approach to migraine patients in specialized headache centers

BackgroundThere is currently a wide therapeutic arsenal for migraine patients, without a single first-line preventive drug and we choose the different available alternatives taking into account comorbidities, national guidelines, previous treatments and personal experiences.Our objective was to evaluate the differences in the use of migraine treatments between neurologists from different countries.MethodsThis is a multi-centre observational study carried out by neurologists from specialized headache units in seven countries, retrospective with consecutive inclusion of all patients presenting with a migraine diagnosis, over a period of three months.ResultsA total of 734 patients were recruited but only 600 were considered in the analysis in order to homogenize the patient cohorts from countries: 200 Spain (ES), 100 Italy (IT), 85 Russia (RUS), 80 Germany (DE), 60 Portugal (PT), 45 Poland (PL) and 30 Australia (AU). 85.4 % of patients were women with a mean age of 42.6 ± 11.8 years. Considering previous and current preventive treatment, the order of use was: antidepressants (69.3 %), antiepileptic drugs (54.7 %), beta-blockers and antihypertensive drugs (49.7 %), OnabotulinumtoxinA (44.0 %) and others (36.2 %).Statistically significant differences were found between all pharmacological classes: antidepressants were commonly used in all countries, with the exception of Poland (AU: 76.7 %, IT: 71.0 %, DE: 60.0 %, PL: 31.1 %, PT: 71.7 %, RUS: 70.6 %, ES: 78.5 %; p < 0.0001); antiepileptic drugs were more frequently prescribed in Portugal, Australia and Spain (AU: 73.3 %, IT: 40.0 %, DE: 37.5 %, PL: 48.9 %, PT: 85.0 %, RUS: 29.4 % and ES: 69.0 %; p < 0.0001); beta-blockers and antihypertensive drugs were frequently used in all countries except Italy (AU: 60.0 %, IT: 14.0 %, DE: 53.8 %, PL: 48.9 %, PT: 68.3 %, RUS: 49.4 % and ES: 59.0 %; p < 0.0001); BTX-A were predominately used in Spain, Italy and Australia (AU:56.7 %, IT:58.0 %, DE:20.0 %, PL: 42.2 %, PT: 26.7 %, RUS: 24.7 % and ES: 58.5 %; p < 0.0001) and others were most frequently used in Poland (AU: 0.0 %, IT: 19.0 %, DE: 42.5 %, PL: 95.6 %, PT: 31.7 %, RUS: 3.5 % and ES: 49.5 %; p < 0.0001). If only patients without comorbidities are considered (200/600), statistically differences between countries persist in all preventive treatments.ConclusionsThere is heterogeneity in the choice of preventive treatment between different countries. Prospective comparative studies of the different oral and subcutaneous alternatives would help to create a global therapeutic algorithm that would guarantee the best option for our patients.     

Serum exosomal microRNAs as predictive markers for EGFR mutations in non–small‐cell lung cancer

BackgroundCurrent therapeutic drugs show positive effects on non–small‐cell lung cancer (NSCLC) patients with mutant epidermal growth factor receptor (EGFR) expression, whereas a lesser beneficial effect is generally noted on NSCLC patients with wild‐type EGFR. Therefore, identification of new detection methods for the accurate clinical diagnosis of NSCLC is essential.MethodsIn this study, tumor‐derived exosomes from the plasma of EGFR mutation and wild‐type NSCLC patients were isolated. Extensive exosomal miRNA profiling of EGFR mutation and wild‐type NSCLC patients, in comparison with healthy individuals, was performed using miRNA‐sequencing analysis.ResultsThe variation of exosomal miRNA expression between control group (NR) and NCSLC samples (AM and AW) was identified. 96 significantly different expressed miRNAs were identified. Of these, 39 miRNAs were upregulated and 57 were downregulated. 11 miRNAs were downregulated, and 31 miRNAs were upregulated in the miRNA expression between NR and AM. Compared with healthy donors, 54 upregulated miRNAs and 36 downregulated miRNAs were observed in samples from AW patients. 40 different expressed miRNAs were identified in AM samples, compared with AW. Ten of upregulated miRNAs are miR‐260, miR‐1169, miR‐117, miR‐15b‐5p, miRNA‐731, miR‐342‐5p, miR‐ 898, miR‐1384, miR‐56, and miR‐1214. Ten of downregulated miRNAs are miR‐99b‐5p, miR‐1116, miR‐689, miR‐818, miR‐604, miR‐72, miR‐955, miR‐403, miR‐1228, and miR‐836.ConclusionThe exosomal miR‐1169 and miR‐260 as potential candidates, which contain specific characteristics that can distinguish between wild‐type EGFR and mutant EGFR NSCLC patients in early‐stage cancers.