Abstract
Gastric cancer is a deadly disease and remains the third leading cause of cancer-related death worldwide. The 5-year overall survival rate of patients with early-stage localized gastric cancer is more than 60%, whereas that of patients with distant metastasis is less than 5%. Surgical resection is the best option for early-stage gastric cancer, while chemotherapy is mainly used in the middle and advanced stages of this disease, despite the frequently reported treatment failure due to chemotherapy resistance. Therefore, there is an unmet medical need for identifying new biomarkers for the early diagnosis and proper management of patients, to achieve the best response to treatment. Long non-coding RNAs (lncRNAs) in body fluids have attracted widespread attention as biomarkers for early screening, diagnosis, treatment, prognosis, and responses to drugs due to the high specificity and sensitivity. In the present review, we focus on the clinical potential of lncRNAs as biomarkers in liquid biopsies in the diagnosis and prognosis of gastric cancer. We also comprehensively discuss the roles of lncRNAs and their molecular mechanisms in gastric cancer chemoresistance as well as their potential as therapeutic targets for gastric cancer precision medicine.
Highlights
Gastric cancer is one of the most common malignancies worldwide, with more than one million new cases every year, and remains the third leading cause of cancerrelated deaths [1, 2]
We focus on the clinical evidence of Long non-coding RNAs (lncRNAs) as biomarkers in liquid biopsies in the early diagnosis and prognosis of gastric cancer
We comprehensively discuss the roles of lncRNAs and their molecular mechanisms in gastric cancer chemoresistance, as well as their potential as therapeutic targets for gastric cancer precise medicine
Summary
Gastric cancer is one of the most common malignancies worldwide, with more than one million new cases every year, and remains the third leading cause of cancerrelated deaths [1, 2]. LncRNAs as liquid biopsy biomarkers of gastric cancer The development of liquid biopsies has opened a new era for precision medical treatment of human cancer Because of their minimal-invasive or non-invasive characteristics and high public acceptance, liquid biopsies can be conducted more frequently for early screening, diagnosis, and prognosis of cancer. Yang et al have found that the AUC values of lncRNA PANDAR (promoter of CDKN1A antisense DNA damage activated RNA), FOXD2-AS1 (FOXD2 adjacent opposite strand RNA 1), and SMARCC2 (SWI/SNF related, matrix associated, actin dependent regulator of chromatin subfamily c member 2) as diagnostic biomarkers of gastric cancer are 0.77, 0.7, and 0.75, respectively, which are similar to the AUC value of combined CEA, AFP, CA125, CA153, and CA199 [97]. Circulating lncRNAs have better biomarker values when combined, e.g. combining lncRNA PANDAR, FOXD2-AS1, and SMARCC2 increases the AUC value
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