| Objective:To detect the expression of seven serum miRNAs of patients with gastric cancer before operation,to study the serum miRNA as a laboratory marker for the diagnosis of gastric cancer,and to evaluate lymph node metastasis of patients with gastric cancer before operation with miRNA.Methods:Among the 254 cases studied,151 cases of gastric cancer were in the experimental group(51 cases in the non-lymph node metastasis group and 100 cases in the lymph node metastasis group),and 103 cases in the health examination group were in the control group.The expression levels of seven miRNAs in 254 serum samples were detected by q RT-PCR,and the contents of CEA,CA19-9 and CA72-4were determined by electrochemiluminescence.Based on six differentially expressed miRNAs in serum,a laboratory combined diagnosis model of miRNAs was constructed by binary logistic regression analysis.Six differentially expressed miRNAs were screened by ROC curve analysis to diagnose gastric cancer and evaluate the value of lymph node metastasis of gastric cancer.Results:1.There was no significant difference in the expression level of miR-21 between the experimental group and the control group(P>0.05).The expression levels of miR-10 b,miR-17,miR-93,miR-143,miR-182 and miR-183 in the serum of patients with gastric cancer increased by 1.22,1.53,1.45,3.24,1.92 and 3.03 times,respectively.The differences of six serum miRNAs between the two groups were statistically significant(P<0.05).2.The ROC curves of six differentially expressed miRNAs in serum of gastric cancer were analyzed.When single miRNAs were used as markers for the diagnosis of gastric cancer,the AUC of miR-10 b,miR-17,miR-93,miR-143,miR-182 and miR-183 were 0.578(95% CI: 0.515-0.640),0.625(95% CI: 0.563-0.685),0.645(95% CI:0.583-0.704),0.812(95% CI: 0.758-0.858),0.753(95% CI: 0.696-0.805)and 0.768(95% CI: 0.711-0.818).The combined diagnostic model of multiple serum miRNAs was constructed by binary logistic regression analysis.Further ROC curve analysis showed that the combination of six miRNAs had the highest diagnostic value(AUC =0.834,95% CI:0.758-0.858).The AUC values of single and combined detection of these six miRNAs were higher than those of combined detection of CEA,CA19-9 and CA72-4(AUC=0.556,95% CI:0.493-0.618).3.No statistical difference was found between the 6 serum miRNAs and age,sex,tumor location,differentiation degree,Lauren typing group(P>0.05).miR-10 b showed statistical difference in tumor size and N stage(P<0.05).miR-17 was associated with T stage,N stage,TNM stage and tumor progression in gastric cancer patients(P<0.05).miR-93,miR-143,miR-182 and miR-183 were all differentially expressed in different N stages and TNM stages of gastric cancer patients(P<0.05),and the expressions of miR-143,miR-182 and miR-183 in the serum of Ⅰ~Ⅱ stage gastric cancer patients were higher than that of normal people.Compared with gastric cancer patients without lymph node metastasis,the expression of miR-10 b,miR-17,miR-93,miR-143,miR-182,miR-183 in the serum of gastric cancer patients with lymph node metastasis was increased by a multiple of 1.42,2.29,1.62,2.15,1.53,2.00,with statistically significant differences(P<0.05).4.ROC curve analysis was performed for serum levels of miR-10 b,miR-17,miR-93,miR-143,miR-182 and miR-183 in patients with lymph node metastasis of gastric cancer,and the AUC were 0.646(95% CI:0.564-0.722),0.761(95% CI:0.788-0.743),0.669(95% CI:0.588-0.743),0.649(95% CI:0.567-0.725),0.673(95% CI:0.592-0.747),0.687(95% CI:0.607-0.760).Multiple serum miRNAs were constructed by binary logistic regression analysis to predict lymph node metastasis,and further ROC curve analysis was carried out.The AUC value of six miRNAs as lymph node metastasis markers was the highest(AUC = 0.789,95%CI:0.715-0.851).Conclusions:1.The serum levels of miR-10 b,miR-17,miR-93,miR-143,miR-182 and miR-183 are significantly higher in patients with gastric cancer.Combination of six serum miRNAs can achieve the highest diagnostic efficiency,which is superior to the commonly used tumor markers CEA,CA19-9,CA72-4,has potential as a marker of gastric cancer.2.The expression of six serum miRNAs in patients with lymph node metastasis of gastric cancer are increased.Combined with six serum miRNAs,it provides a new method for the preoperative evaluation of lymph node metastasis of gastric cancer. |
PDF Full Text Request