Diagnosis Of Gastric Carcinoma Research Articles

Clinicopathological Correlation of P53 Protein Expression in different Histological Subtypes of Gastric Carcinoma

Introduction: Gastric cancer is one of the common cancers after lung cancer worldwide, especially in the developing countries. p53 immunohistochemical expression has been proposed as a potential tool to evaluate the biological behavior of gastric cancer. However, its practical implication in gastric cancer prognosis or treatment by restoration of mutated p53 function is yet to be fully exploited. Hence, this study with the aim of assessing the yield of p53 expression in gastric carcinoma and its relationship with various clinicopathological parameters was formulated. Objectives: To assess immunohistochemical expression of p53 protein in different histological subtypes of gastric carcinoma cases and to study correlation between p53 protein expression and different clinicopathological parameters like age, gender, tumour location, gross pattern, histological types, degree of tumor differentiation and pathological staging in the above said cases. Materials and Methods: This was a hospital based cross-sectional study done over a period of 18 months on 60 cases of gastrectomies with proven histological diagnosis of gastric carcinoma. Observation and Results: Strong p53 expression was frequent among elderly male patients (>60 years) who had ulceroproliferative tumors, located at pyloric antrum belonging to pTNM stage IIIA. In 87% cases, it was expressed, predominantly in moderately differentiated intestinal type with serosal invasion. Also, cases even with no lymph node metastasis showed p53 expression. Conclusion: Few findings were contradictory to other similar studies e.g. lymph node negative cases showing P53 expression does not support the hypothesis of predicting lymph node status by p53 expression. No significant correlation between p53 expression and different clinicopathological parameters in gastric carcinoma cases was seen. Keywords: P53, immunohistochemical, clinicopathological, histological subtypes, metastasis

Clinical value assessment for serum hsa_tsr013526 in the diagnosis of gastric carcinoma.

Gastric carcinoma (GC) is a malignant tumor that is detrimental to human health. Transfer RNA-derived small RNAs are a newly identified class of noncoding small RNAs with specific biological functions that are aberrantly expressed in cancer. The aim of this study was to investigate the potential of hsa_tsr013526 as a biomarker for GC. Quantitative real-time fluorescence polymerase chain reaction was used to detect the expression level of hsa_tsr013526. The molecular characteristics of hsa_tsr013526 were verified by agarose gel electrophoresis, Sanger sequencing, and separation of nuclear and cytoplasmic RNA fractions. By testing the receiver operating characteristic (ROC) curves, the diagnostic efficiency of GC using hsa_tsr013526 was determined. Finally, we predicted the downstream of hsa_tsr013526 using functional assays and bioinformatics analysis. Serum expression of hsa_tsr013526 was higher in GC patients than in healthy donors. Serum expression showed differential changes in GC patients, gastritis patients, and healthy donors. Chi-squared tests showed that high expression of hsa_tsr013526 was significantly correlated with T stage, lymphatic metastasis, and tumor node metastasis stage. ROC curve analysis indicated that GC patients could be discriminated from healthy donors or gastritis patients based on their serum levels of hsa_tsr013526. Furthermore, hsa_tsr013526 expression was significantly reduced in postoperative GC patients (p = .0016). High expression of hsa_tsr013526 promotes gastric cancer cell proliferation, invasion, and migration. Serum hsa_tsr013526 was stable and specific, and could be used for dynamic monitoring of GC patients. Therefore, hsa_tsr013526 may be a new biomarker for the diagnosis and postoperative monitoring of GC patients.

Update on diagnosis and treatment of early signet-ring cell gastric carcinoma: A literature review.

Gastric signet-ring cell gastric carcinoma (GSRC) is an unfavorable subtype of gastric cancer (GC) that presents with greater invasiveness and poorer prognosis in advanced stage than other types of GC. However, GSRC in early stage is often considered an indicator of less lymph node metastasis and more satisfying clinical outcome compared to poorly differentiated GC. Therefore, the detection and diagnosis of GSRC at early stage undoubtedly play a crucial role in the management of GSRC patients. In recent years, technological advancement in endoscopy including narrow-band imaging and magnifying endoscopy has significantly improved the accuracy and sensitivity of the diagnosis under endoscopy for GSRC patients. Researches have confirmed that early stage GSRC that meets the expanded criteria of endoscopic resection showed comparable outcomes to surgery after receiving endoscopic submucosal dissection (ESD), indicating that ESD could be considered standard treatment for GSRC after thorough selection and evaluation. This article summarizes the current knowledge and updates pertaining to the endoscopic diagnosis and treatment of early stage signet-ring cell gastric carcinoma.

Synchronous double malignancies in patients with gastric cancer: A case series.

Background: Synchronous cancers are defined as two or more cancers diagnosed simultaneously or within an interval of 6 months after the diagnosis of primary cancer. They are attributed to similar genetic mutations and genetic susceptibility. Methods: All the patients with gastric cancer and synchronous malignancies who underwent surgery were included from 1996 to 2022. Data were extracted from the case records. The analysed data included age, sex, intraoperative procedure, and histopathology report. Results: During this period, 7 cases underwent surgical treatment for dual malignancy with a diagnosis of gastric carcinoma. The second malignancy site was the genitourinary system (5 cases), colon (1 case) and left forearm (1 case). Conclusion: Synchronous double malignancies in gastric cancer pose a challenge to treating physicians. Proper staging of the disease is needed and treatment planning should include a multidisciplinary approach.

Minimally invasivE versus open total GAstrectomy (MEGA): study protocol for a multicentre randomised controlled trial (DRKS00025765)

IntroductionThe only curative treatment for most gastric cancer is radical gastrectomy with D2 lymphadenectomy (LAD). Minimally invasive total gastrectomy (MIG) aims to reduce postoperative morbidity, but its use has not...

The role of circular RNA hsa_circ_0001789 as a diagnostic biomarker in gastric carcinoma

Background Circular RNA (circRNA) is a kind of endogenous non-coding RNAs and has shown diagnostic values in various cancers. This study aimed to explore whether hsa_circ_0001789 could be a novel biomarker for gastric cancer (GC). Methods Quantitative reverse transcriptase PCR was used to detect the expression of hsa_circ_0001789 in 108 paired GC and paracancerous tissues as well as in 24 paired plasma specimens. Possible associations between hsa_circ_0001789 expression and clinicopathologic factors of GC patients were examined using one-way ANOVA. A receiver operating characteristic (ROC) curve was established to investigate the diagnostic value of hsa_circ_0001789 in GC. Results GC tissues and plasma samples showed down-regulated hsa_circ_0001789 levels than their counterparts, which were closely correlated with the malignant characteristics of GC. The area under the ROC curve (AUC) of hsa_circ_0001789 in GC tissues was 0.82, while the cut-off value was 9.5, indicating a favorable diagnostic value. Compared with the traditional tumor biomarkers, hsa_circ_0001789 had preferred AUCs that reached 0.786 for predicting the stage of invasion, 0.603 for predicting the stage of lymphatic metastasis, 0.722 for predicting the stage of distant metastasis, and 0.786 for predicting TNM stage. Conclusions Hsa_circ_0001789 may be a novel biomarker for the diagnosis of gastric carcinoma.

Can Chromoendoscopy Improve the Early Diagnosis of Gastric Carcinoma in Dogs?

Simple SummaryCurrently, canine gastric carcinoma is mainly diagnosed in its late, incurable phase, and strategies for early diagnosis are lacking. In human medicine, chromoendoscopic (CE) methods such as staining the gastric mucosal surface with indigo carmine (IC), and narrow band imaging (NBI), have improved the diagnosis of precancerous gastric mucosal changes and early gastric carcinoma. This study aimed at investigating whether IC-CE and NBI-CE can improve the diagnostic yield of endoscopy in dogs. Belgian Shepherd dogs are predisposed to gastric carcinoma; thus, 30 dogs of the breed served as the study population. As a result, the study revealed that especially the combination of standard white light endoscopy (WLE) with NBI-CE allows better recognition of gastric mucosal structural changes than WLE alone. However, CE assessment templates used to predict the type of mucosal change in humans were not applicable in dogs. The value of the study lies in providing evidence that CE can improve the diagnosis of precancerous changes and early gastric carcinoma in dogs. However, current image assessment templates from human medicine need major adjustments to comprehend canine gastric mucosal conditions.Chromoendoscopy has improved the early diagnosis of gastric cancer in humans but its usefulness in dogs is unknown. This study aimed at assessing whether adding narrow band imaging (NBI) or indigo carmine (IC) chromoendoscopy (CE) can improve the diagnostic yield of standard white light endoscopy (WLE). We compared the real-time findings of canine WLE, NBI-CE, and IC-CE and corresponding histology reports with endoscopic mucosal pattern assessment templates used in human medicine. Belgian Shepherd dogs are predisposed to gastric carcinoma. Therefore, 30 dogs of this breed served as the study population. According to histology, 17/30 dogs had mucosal changes (mucous metaplasia, glandular dysplasia, and gastric carcinoma). Diagnostic yield was best when targeted biopsies were taken with WLE and NBI-CE combined (15/17 cases). WLE alone positively identified only 8/17 cases and missed a gastric carcinoma in 3/6 cases. CE assessment templates based on macroscopic mucosal patterns, broadly used in human medicine, were not readily applicable in dogs. In conclusion, the study provides evidence that using CE in dogs has the potential to improve the diagnosis of precancerous gastric mucosal pathology and early gastric carcinoma. However, current image assessment templates from human medicine need major adjustments to the patterns of canine gastric mucosa.

Dynamic detection of HER2 of circulating tumor cells in patients with gastric carcinoma and its clinical application.

The aim of the present study was to construct and characterize human epidermal growth factor receptor2 (HER2) lipid magnetic ball (H‑LMB) for separating circulating tumor cells (CTCs) in patients with gastric carcinoma (GC) and to compare the result of separated CTC counts with that of next‑generation sequencing (NGS) for single‑gene analysis to verify the consistency for evaluating the association between the detection results and the progress of clinical treatment, so as to facilitate early diagnosis and dynamic monitoring of GC. A lipid magnetic ball (LMB), coated with Fe3O4 nanoparticles, was synthesized by microemulsion technique and an anti‑HER2 antibody was conjugated to the surface of LMB to form H‑LMB, followed by the characterization of the prepared H‑LMB. The detection of capture efficiency of LMBs in GC cells was tested by MTT and expression of HER2 mRNA was determined by reverse transcription‑quantitative PCR. The positive detection rate of HER2 was verified by HER2‑fluorescence insitu hybridization (FISH) test on the separated CTCs from GC. Further verification was performed based on the consistency between the result of separated CTCs and that of single‑gene NGS assay of HER2, associated with the determination of clinical consistency. The constructed H‑LMB exhibited good stability and specificity. The mutation rate of HER2 by the FISH test was 14% in the blood samples of 50patients with GC and was 14% by NGS assay. The mutation rate of HER2 was 12% in H‑LMB and the positive detection rate was 85.7% compared with the results of the FISH test, indicating consistency with the clinical diagnosis and pathological examination results. In conclusion, the anti‑HER2 antibody‑modified LMB can separate CTCs with HER2 abnormal expression, which exhibits an application potential in GC diagnosis and treatment and is of great clinical significance for the diagnosis and evaluation of its therapeutic effect on GC.

Hypofractionated radiotherapy provides palliation for a dog with advanced gastric carcinoma

AbstractAn 11‐year‐old, female, spayed border collie displayed vomiting and diarrhoea for a period of 3 months and presented with severe emaciation. A laparotomy confirmed the presence of a gastric lesion, and histopathologic evaluation revealed a diagnosis of gastric carcinoma. The dog was treated with hypofractionated intensity‐modulated radiation therapy and achieved clinical improvement for approximately 3 months after treatment. Given the improvement of clinical signs following treatment in this case, the use of radiation therapy as a treatment option may be explored for palliation for dogs with advanced gastric carcinoma.

Diagnostic and prognostic value of MATN3 expression in gastric carcinoma: TCGA database mining.

Globally, the high morbidity and mortality of gastric carcinoma (GC) have been one of the great challenges facing humanity. However, the early diagnosis of GC is still unknown. Matrilin-3 (MATN3) is a member of the extracellular matrix (ECM) protein family. Previous studies have reported a correlation between the expression of MATN3 and bone disease. However, the role of MATN3 in GC has not been reported in depth, which can have a possible far-reaching implication for GC. We explored the diagnostic and prognostic value and pathway enrichment of MATN3 expression in GC. Limma package conducted by R was used to analysis the difference expression data of MATN3 from The Cancer Genome Atlas (TCGA). The receiver operating characteristic (ROC) curve analysis was used to estimate the diagnostic value of MATN3 expression. univariate and multivariate analysis were used to assess the prognostic value of MATN3, and gene set enrichment analysis (GSEA) to identify the enriched signaling pathways. MATN3 was found to be significantly higher in GC tissue samples. GC patients with high MATN3 expression had poor prognosis. Then, GSEA showed that the gene sets were correlated with signaling pathways including ECM receptor interaction, hypertrophic cardiomyopathy (HCM), and glycosaminoglycan biosynthesis chondroitin sulfate, among others. The study suggests that MATN3 can serve as a potential diagnostic and prognostic biomarker for GC.

Highly Sensitive and Cost-Effective Portable Sensor for Early Gastric Carcinoma Diagnosis

Facile and efficient early detection of cancer is a major challenge in healthcare. Herein we developed a novel sensor made from a polycarbonate (PC) membrane with nanopores, followed by sequence-specific Oligo RNA modification for early gastric carcinoma diagnosis. In this design, the gastric cancer antigen CA72-4 is specifically conjugated to the Oligo RNA, thereby inhibiting the electrical current through the PC membrane in a concentration-dependent manner. The device can determine the concentration of cancer antigen CA72-4 in the range from 4 to 14 U/mL, possessing a sensitivity of 7.029 µAU−1mLcm−2 with a linear regression (R2) of 0.965 and a lower detection limit of 4 U/mL. This device has integrated advantages including high specificity and sensitivity and being simple, portable, and cost effective, which collectively enables a giant leap for cancer screening technologies towards clinical use. This is the first report to use RNA aptamers to detect CA72-4 for gastric carcinoma diagnosis.

Identification of anti-Epstein-Barr virus (EBV) antibody signature in EBV-associated gastric carcinoma.

Around 10% of gastric carcinomas (GC) contain Epstein-Barr virus (EBV) DNA. We characterized the GC-specific antibody response to this common infection, which may provide a noninvasive method to detect EBV-positive GC and elucidate its contribution to carcinogenesis. Plasma samples from EBV-positive (n = 28) and EBV-negative (n = 34) Latvian GC patients were immune-profiled against 85 EBV proteins on a multi-microbial Nucleic Acid Programmable Protein Array (EBV-NAPPA). Antibody responses were normalized for each sample as ratios to the median signal intensity (MNI) across all antigens, with seropositivity defined as MNI ≥ 2. Antibodies with ≥ 20% sensitivity at 95% specificity for tumor EBV status were verified by enzyme-linked immunosorbent assay (ELISA) and validated in independent samples from Korea and Poland (n = 24 EBV-positive, n = 65 EBV-negative). Forty anti-EBV IgG and eight IgA antibodies were detected by EBV-NAPPA in ≥ 10% of EBV-positive or EBV-negative GC patients, of which nine IgG antibodies were discriminative for tumor EBV status. Eight of these nine were verified and seven were validated by ELISA: anti-LF2 (odds ratio = 110.0), anti-BORF2 (54.2), anti-BALF2 (44.1), anti-BaRF1 (26.7), anti-BXLF1 (12.8), anti-BRLF1 (8.3), and anti-BLLF3 (5.4). The top three had areas under receiver operating characteristics curves of 0.81-0.85 for distinguishing tumor EBV status. The EBV-associated GC-specific humoral response was exclusively directed against lytic cycle immediate-early and early antigens, unlike other EBV-associated malignancies such as nasopharyngeal carcinoma and lymphoma where humoral response is primarily directed against late lytic antigens. Specific anti-EBV antibodies could have utility for clinical diagnosis, epidemiologic studies, and immune-based precision treatment of EBV-positive GC.

Gastric Carcinoma with Lymphoid Stroma: A Rare Case Report with EBV Negativity

Abstract Introduction/Objective Gastric carcinoma with lymphoid stroma (GCLS) is a distinct and rare histologic subtype of gastric adenocarcinoma that is characterized by undifferentiated carcinoma mixed with prominent lymphoid cell infiltration. Around 80% of GCLS cases are associated with Epstein-Barr virus (EBV) infection. Here we report a case of EBV-negative GCLS. Methods The patient was a 79-year-old female with a recent history of abdominal distention, weight loss, and gastrointestinal bleeding who presented for evaluation. Endoscopy found a 4.6 mm lobulated lesion at the incisura of the stomach with endosonographic evidence of invasion through the submucosa. Biopsy was consistent with intramucosal diffuse neoplasm, favoring adenocarcinoma. The decision was made to do subtotal gastrectomy. Results The patient underwent distal gastrectomy with Billroth 2 reconstruction. Gross examination of the stomach revealed a firm 1.4 cm nodule in the background of diffuse mucosal granularity in the adjacent stomach. Microscopically, the tumor invaded the submucosa without lymph nodes involvement. Staining showed the tumor diffusely positive for CAM5.2, focally and weakly positive for pancytokeratin and CK7, while negative for CK20. Mismatch repair (MMR) proteins staining demonstrated a loss of nuclear expression of MLH1 and PMS2. Her2/Neu FISH was non-amplified. The tumor was found to be EBV negative by EBER ISH while PD-L1 was expressed. The histopathological findings confirmed the final diagnosis of gastric carcinoma with lymphoid stroma (GCLS). Conclusion We report a case of GCLS that was EBV negative with non-amplified HER2, while MMR-deficient, and PD-L1 positive. These results suggest that this tumor subtype may be less responsive to targeted therapy, but show susceptibility to immune checkpoint inhibitors.

Synchronous Bilateral Ureteric Metastases as the Presenting Manifestation of Gastric Cancer

A 55-year-old man sought medical attention because of the right flank pain. He was anemic with impaired renal function and was admitted to the hospital. Computer tomography demonstrated bilateral hydronephrosis due to ureteral obstruction. Biopsy of both ureters and immunohistochemical staining led to the final diagnosis of gastric carcinoma metastasizing to both ureters. This article presented a case in which metastases of the ureters were the first and sole presentation of gastric cancer.

Diagnostic value and clinical significance of circulating miR-650 and CA211 in detecting of gastric carcinoma.

The present study determined the levels of plasma biomarkers in patients with gastric carcinoma (GC) and investigated their clinical significance and diagnostic value. Between April 2014 and December 2018, 90 patients with GC, 90 patients with precancerous lesions (Pre) and 45 healthy controls (NC) were recruited from the Affiliated Liutie Central Hospital of Guangxi Medical University. Five markers were measured: microRNA-650 (miRNA-650; using reverse transcription-quantitative polymerase chain reaction), and carcinoembryonic antigen (CEA), carbohydrate antigen (CA)125, CA211 and CA50 using electrochemiluminescence. Circulating markers were all upregulated in patients with GC (P<0.05), and CA211 and CA50 were significantly increased in patients with Pre. The miRNA-650 and CA211 had an area under the curve (AUC) of 0.700 (moderate) and 0.866 (high), respectively, in the diagnosis of GC. Differentiation of GC from Pre yielded an AUC of 0.665 (low) and 0.708 (moderate), respectively. The combination model of miRNA-650 and CA211 showed an appropriate value of AUC (0.887) to discriminate the GC patients from the healthy subjects with a sensitivity and specificity of 82.5 and 97.7%. Additionally, differentiating GC from Pre yielded an AUC of 0.767 with a sensitivity of 57.1% and a specificity of 95%, respectively. In terms of clinicopathological features, the expression of miRNA-650 and CA211 in plasma was not associated with the patients' age, sex, Tumor-Node-Metastasis stage, or histological type. In conclusion, plasma miRNA-650 and CA211 is a promising and powerful non-invasive marker for the detection of GC.

Circular RNA hsa_circRNA_102958 may serve as a diagnostic marker for gastric cancer.

Circular RNAs (circRNA) play key regulatory roles in cancer progression. Human circRNA microarray was performed to screen for abnormally expressed circRNA in gastric cancer tissues. In this study, we found circRNA102958 was up-regulated in gastric cancer tissues and cell lines. The hsa_circRNA_102958 levels were detected by quantitative reverse transcription-polymerase chain reaction (qRT-PCR) in gastric tissue and cell. Then, the association between the expression level of hsa_circRNA_102958 and the clinicopathological features of patients with gastric cancer was further analyzed. Finally, a network of hsa_circRNA_102958-miRNA-mRNA interactions was predicated. In this study, we analyzed 30 patients and found that hsa_circRNA_102958 was significantly overexpressed in gastric cancer tissues compared with paired adjacent normal tissues. Clinicopathological features showed that hsa_circRNA_102958 level in GC tissues was positively associated with TNM stage (p= 0.032). The area under the ROC curve was 0.74. Finally, a total of 5 miRNAs were predicted to have an interaction with hsa_circRNA_102958. hsa_circRNA_102958 may be a potential novel and stable biomarker for the diagnosis of gastric carcinoma.

Gastric biopsies that keep you up at night

The diagnosis of gastric carcinoma can be challenging in several situations. Diffuse-type carcinomas can be readily overlooked, especially when inconspicuous tumour cells infiltrate between benign gastric glands and elicit little, if any, stromal response. Metastases, particularly from the breast, bear striking similarities with gastric carcinomas and should always be considered in the differential diagnosis when poorly cohesive tumours develop in women. Benign mimics of diffuse-type adenocarcinoma can also result from artifactual or inflammation-induced disruption of non-neoplastic gastric epithelium. Benign foveolar epithelial cells assume a globoid appearance (i.e., signet ring cell change) when they are not confined to the basement membrane. Tubular adenocarcinomas show glandular crowding, branching, villiform or cribriform growth, and cystically dilated crypts that can simulate regenerative atypia. Rare tumours are extremely well-differentiated with minimal architectural abnormalities and only slight nuclear enlargement. Distinction between primary carcinomas and their potential mimics will be discussed during the presentation.

Serum miR-191 and miR-425 as Diagnostic and Prognostic Markers of Advanced Gastric Cancer Can Predict the Sensitivity of FOLFOX Chemotherapy Regimen.

PurposemiR-191 and miR-425 have been proved to be highly expressed in gastric carcinoma (GC). However, little research has been done on their clinical value in serum of patients with advanced GC. In addition, it is not clear whether they can be used as markers for the response and prognosis of GC patients treated with oxaliplatin combined with 5-fluorouracil and FOLFOX chemotherapy.Patients and MethodsA total of 230 patients with advanced GC admitted to our hospital were selected as the study objects, all of whom received FOLFOX chemotherapy regimen. Another 100 cases of healthy subjects were included. QRT-PCR was employed to detect the serum expression of miR-191 and miR-425 in patients.ResultsCompared with the healthy subjects, the serum expressions of miR-191 and miR-425 in GC patients were significantly upregulated, which were correlated with differentiation degree and TNM staging, respectively. According to the ROC curve, the AUC of miR-191 and miR-425 for GC diagnosis was 0.937 and 0.901, respectively, while the AUC for differentiation degree diagnosis was 0.854 and 0.822, and that for TNM staging diagnosis was 0.860 and 0.829, respectively. The predictive AUC of miR-191 and miR-425 for chemosensitivity was 0.868 and 0.835, respectively, with a combined predictive AUC of 0.935. Low differentiation degree, high TNM staging, high miR-191 and high miR-425 expressions were independent risk factors for chemotherapy insensitivity. Differentiation degree, TNM staging, chemotherapy effect, miR-191 and miR-425 were independent influencing factors for the prognosis of GC patients.ConclusionUp-regulated expression of miR-191 and miR-425 in the serum of patients with advanced GC are effective biomarkers for the diagnosis, chemotherapy and prognosis evaluation of GC.

Validity of serum amyloid A and HMGB1 as biomarkers for early diagnosis of gastric cancer.

Background and aimGastric carcinomais a frequent neoplasm with poor outcome, and its early detection would improve prognosis. This study was designed to evaluate the possible use of new biomarkers, namely SAA and HMGB1, for early diagnosis of gastric cancer.MethodsA total of 100 patients presenting with gastric symptoms were included. All patients underwent upper endoscopic evaluation, histopathological diagnosis and serum CEA, SAA, and HMGB1 measurements.ResultsPatients were classed endoscopically with neoplastic, inflammatory, and normal-appearing gastric mucosa: 50, 25, and 25 patients, respectively. Histologically, half the patients had chronic gastritis and the remaining cases gastric carcinoma of diffuse (n=28) or intestinal (n=22) type. SAA at cutoff of 18.5 mg/L had the best validity to differentiate gastritis from gastric carcinoma, with AUC, sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of 0.99, 98%, 100%, 100%, and 98%, respectively, followed by HMGB1 at cutoff of 14.5 pg/μL, with AUC, sensitivity, specificity, PPV, and NPV of 0.91, 70%, 96%, 94.6%, and 76.2%, respectively. Sensitivity, specificity, PPV, and NPV of serum CEA at cutoff of 2.9 ng/mL to differentiate gastritis from gastric carcinoma were 42%, 72%, 60%, and 55.4%, respectively, with AUC of 0.53. Nonetheless, higher serum levels of both SAA and HMGB1 reflected higher tumor grade (P=0.027 and P=0.016, respectively) and advanced tumor stage (P-OBrk-0.001 for both).ConclusionSerum levels of both SAA and HMGB1 could be of great value for early diagnosis of gastric carcinoma, comparable to the diagnostic role of serum CEA, which is not valid for early diagnosis of gastric cancer.

TRFs as Potential Exosome tRNA-Derived Fragment Biomarkers for Gastric Carcinoma.

Gastric Carcinoma (GC) is one of the common diseases induced by the interaction of genes and environment. Exosomes are potential markers for several health problems, which contain lipids, proteins, long non-coding RNAs, microRNAs (miRNAs), and tRNA-derived fragments (tRFs). The roles of mRNAs and miRNAs in GC have been studied comprehensively; however, little research was focused on the function of plasma exosomal tRFs. We collected plasma samples from fifty healthy controls and fifty GC patients, and all exosomes were isolated with a combined centrifugation and characterized by electron microscopy, western blot, and flow cytometry. The small RNA sequence was performed to detect the plasma exosomal tRFs, and tRFs markers were validated by real-time quantitative PCR. Three exosomal diagnostic tRFs were confirmed by receiver operating characteristic analyses. In this study, we found higher plasma exosomal tRF-25, tRF-38, tRF-18 expression in GC than in controls. Plasma exosomal tRF-25, tRF-38, and tRF-18 showed better accuracy for GC diagnosis. Our results suggest that plasma exosomal tRF-25, tRF-38, and tRF-18 were biomarkers for GC detection; tRF-25, tRF-38 and tRF-18 might be predictive of GC prognosis.