Abstract
Serum miRNAs have gained great popularity to act as circulating biomarkers of several cancers. In this study, we aimed to evaluate the diagnostic efficiency of serum miR-21 as novel biomarkers for patients with hepatocellular carcinoma (HCC) and other controls. A total of 533 individuals were recruited and conducted in a two-step analysis. The pilot group included 40 HCC patients and 40 healthy donors. The expression levels of miR-21 were significantly higher in primary HCC tissues than in adjacent noncancerous tissues (P<0.0001). HCC patients exhibited significantly higher serum levels of miR-21 than HD (P<0.0001). In the verification group, the mean serum levels of miR-21 in 175 patients with HCC were significantly higher than in 64 with CHB, 78 with LC and 136 HD (all P<0.0001). ROC curves demonstrated that the AUC of miR-21 was 0.849, sensitivity 82.1% and specificity 83.9%. Furthermore, serum miR-21 maintained its diagnostic efficiency in AFP-negative HCC subgroups with AUC 0.831, sensitivity 81.2% and specificity 83.2%. The serum levels of miR-21 could distinguish HCC from CHB and LC (AUC 0.789, sensitivity 76.9%, specificity 85.7% and AUC 0.814, sensitivity 80.8%, specificity 72.9%, respectively). In addition, the serum levels of miR-21 were significantly associated with clinical stage (P=0.006) and distant metastasis (P=0.000). Thus, our findings suggest that miR-21 together with AFP may help enhance the diagnosis of HCC, especially of AFP-negative HCC, and could distinguish HCC from CHB and LC.
Highlights
Hepatocellular carcinoma (HCC) is the second most common gastrointestinal solid tumors and remains the second leading cause of cancer-related death in China [1]
We aimed to evaluate the diagnostic efficiency of serum miR-21 as novel biomarkers for patients with hepatocellular carcinoma (HCC) and other controls
Our findings suggest that miR-21 together with AFP may help enhance the diagnosis of HCC, especially of AFP-negative HCC, and could distinguish HCC from chronic HBV infection (CHB) and liver cirrhosis (LC)
Summary
Hepatocellular carcinoma (HCC) is the second most common gastrointestinal solid tumors and remains the second leading cause of cancer-related death in China [1]. It is estimated that more than half of newly diagnosed cases of HCC and cancer-related deaths may occur in China [2]. Surgical resection remains the potential curative treatment for patients with HCC, only 30-40% ones are operable partly due to the lack of effective methods of diagnosis in time. A-fetoprotein (AFP) is the only biomarker commonly used for screening of HCC. The diagnostic efficiency of α-fetoprotein remains unsatisfied for its elevations in patients with liver benign diseases (liver cirrhosis and chronic hepatitis) and screening of early-stage HCC [3]. Identification of novel biomarkers for HCC to complement AFP is urgently needed
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