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Background: Increasing evidence illustrates that exosomal microRNAs in circulating fluids provide a promising ay as biomarkers for noninvasive cancer diagnosis. The aim of this study as to evaluate the feasibility of exosomal miRNAs as a diagnostic and prognostic biomarkers in non-small-cell lung cancer NSCLC . Methods: Blood samples from 40 NSCLC patients and 24 healthy volunteers ere collected and matched ith age, gender and blood collection time. Plasma exosomes ere accessed by 110,000xD7;g ultracentrifugation and visualized by NS300 equipment. The ra data of exosomal miRNA profiles of NSCLC patients and healthy individuals ere generated by NGS around 400xD7; read depth and its expression ere measured by Taqman probe quantitive PCR. . Results: Exosome numbers ere robust in differentiating NSCLC patients from controls [area under the curve AUC = 0.800; 95 percent confidence interval CI = 0.6850.915 P lt 0.01]. RNA sequencing data shoed 31 miRNAs ere up-regulated and 55 miRNAs don-regulated in plasma of NSCLC. TaqMan quantitative RT-PCR analyses indicated that miR-99a, miR-124 and miR-214 ere significantly loer in NSCLC patients than in controls. Hoever, miR-21 and miR-126 had significantly higher expression in NSCLC patients. Mir-214 shoed high accuracy in discriminating NSCLC patients from healthy controls ith a sensitivity of 0.70 and specify of 0.92 AUCx2009; = x2009;0.858, 95 percent CI = 0.7650.950 P lt 0.001 . Furthermore, decreased miR-99a expression as positively correlated ith TNM stage P = 0.007 , lymph node metastasis P = 0.012 , and distant metastasis P lt 0.001 . Increased miR-21 expression as significantly associated ith poorer pathological differentiation P = 0.015 , tumor size P = 0.033 , and lymph node metastasis P = 0.028 . KaplanMeier analysis demonstrated that decreased miR-99a expression contributed to poor progression-free survival PFS P lt 0.01 of patients. Multivariate analysis indicated that miR-99a as a independent prognostic marker of survival. Conclusions: Exosomal miRNAs in plasma could indicate the progress of NSCLC and a combination of the explored miRNA could serve as a promising biomarker for NSCLS diagnosis and prognosis.,J Clin Oncol 34, 2016 suppl; abstr e20004 ,Publication Only Lung CancerNon-Small Cell Local-RegionalSmall CellOther Thoracic Cancers