Circulating serum exosomal miR-92a-3p as a novel biomarker for early diagnosis of gastric cancer

Gastric cancer (GC) is one of the common malignant tumors with high mortality. The abundance of miRNAs in serum exosomes has proved to have a high application value as a new noninvasive diagnostic method. The purpose of this study was to investigate whether serum exosomal miR-92a-3p could be used as a new biomarker for early diagnosis of GC and evaluate its clinical application value by detecting the expression of serum exosomal miR-92a-3p in 131 patients with primary GC and 122 healthy controls by real-time quantitative (qRT)-PCR. The results showed that the expression level of serum exosomal miR-92a-3p in GC patients was significantly lower than that in normal controls (p < 0.0001). In addition, the level was closely correlated with lymph node metastasis and tumor node metastasis stage of GC patients. The area under the curve for serum exosomal miR-92a-3p was 0.829, significantly higher than for other indicators. Furthermore, combined detection of serum exosomal miR-92a-3p, CEA and CA19-9 was more sensitive than any of the three alone or any pair. These results showed that serum exosomal miR-92a-3p could be used as a novel new tumor biomarker to improve diagnostic efficiency in GC.

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Prognostic and Clinicopathological Value ofPINX1in Various Human Tumors: A Meta-Analysis

BioMed Research International ◽

10.1155/2018/4621015 ◽

2018 ◽

Vol 2018 ◽

pp. 1-10

Author(s):

Hao Liang ◽

Zhiyong Xiong ◽

Ying Li ◽

Weihao Kong ◽

Zhicheng Yao ◽

...

Keyword(s):

Malignant Tumors ◽

Meta Analysis ◽

Clinicopathological Characteristics ◽

Lymphatic Invasion ◽

Tumor Biomarker ◽

Tumor Node Metastasis ◽

Free Survival ◽

Node Metastasis ◽

Advanced Tumor ◽

Tumor Node Metastasis Stage

PINX1(Pin2/TRF1 interacting protein X1, an intrinsic telomerase inhibitor and putative tumor suppressor gene) may represent a novel prognostic tumor biomarker. However, the results of previous studies are inconsistent and the prognostic value ofPINX1remains controversial. Therefore, we conducted a meta-analysis to determine whetherPINX1expression is associated with overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS), recurrence-free survival (RFS), and clinicopathological characteristics in patients with malignant tumors. A systematic search was performed in the PubMed, Web of Science, and Embase databases in April 2018. Quality assessment was performed according to the modified Newcastle-Ottawa Scale. Pooled odds ratios (ORs) and hazard ratios (HRs) with 95.0% confidence intervals (CIs) were calculated to determine the relationship betweenPINX1expression and OS, DSS, DFS/RFS, and clinicopathological characteristics. Due to the heterogeneity across the included studies, subgroup and sensitivity analyses were performed. Fixed-effects models were used when the heterogeneity was not significant and random-effects models were used when the heterogeneity was significant. Fourteen studies of 16 cohorts including 2,624 patients were enrolled. LowPINX1expression was associated with poor OS (HR: 1.51, 95.0% CI: 1.03–2.20;P= 0.035) and DFS/RFS (HR: 1.78, 95.0% CI: 1.28–2.47;P= 0.001) but not DSS (HR: 0.80, 95.0% CI: 0.38–1.67;P= 0.548). LowPINX1expression was also associated with lymphatic invasion (OR: 2.23, 95.0% CI: 1.35–3.70;P= 0.002) and advanced tumor-node-metastasis stage (OR: 2.43, 95.0% CI: 1.29–4.57;P= 0.006). No significant associations were observed between lowPINX1expression and sex, depth of invasion, grade of differentiation, and distant metastasis. LowPINX1expression was associated with poor OS and DFS/RFS and lymphatic invasion and advanced tumor-node-metastasis stage, suggesting thatPINX1expression may be a useful predictor of prognosis in patients with malignant tumors.

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Prognostic Value of Pretreatment Systemic Immune-Inflammation Index in Gastric Cancer: A Meta-Analysis

Frontiers in Oncology ◽

10.3389/fonc.2021.537140 ◽

2021 ◽

Vol 11 ◽

Author(s):

Ye Qiu ◽

Zongxin Zhang ◽

Ying Chen

Keyword(s):

Gastric Cancer ◽

Prognostic Value ◽

Meta Analysis ◽

Disease Free Survival ◽

Positive Lymph Node ◽

Node Metastasis ◽

Advanced Tumor ◽

Tumor Node Metastasis Stage ◽

Immune Inflammation

BackgroundPrevious studies have investigated the role of systemic immune-inflammation index (SII) as a prognostic factor for gastric cancer (GC) patients, although with inconsistent results. Thus, the aim of this study was to identify the prognostic value of SII in GC through meta-analysis.MethodsWe systematically searched the PubMed, Embase, and Web of Science databases for relevant studies investigating the prognostic role of SII in GC up to December 2019. The hazard ratios (HRs) and 95% confidence intervals (CIs) related to overall survival (OS) and disease-free survival (DFS) were combined. Odds ratios (ORs) and 95% CIs were pooled to assess the correlation between SII and clinicopathological features of GC.ResultsA total of eight studies, comprising 4,236 patients, were included in this meta-analysis. Pooled analysis indicated that a high pretreatment SII predicted poor OS (HR=1.40, 95% CI=1.08–1.81, p=0.010) but not poor DFS (HR=1.30, 95% CI=0.92–1.83, p=0.140) in GC. In addition, an elevated SII correlated with an advanced tumor–node–metastasis stage (OR=2.34, 95% CI=1.40–3.92, p=0.001), T3–T4 stage (OR=2.25, 95% CI=1.34–3.77, p=0.002), positive lymph node metastasis (OR=1.79, 95% CI=1.12–2.87, p=0.016), and tumor size ≥ 5 cm (OR=2.28, 95% CI=1.62–3.22, p<0.001) in patients with GC.ConclusionsA high pretreatment SII significantly associated with poorer survival outcomes as well as several clinical characteristics in GC. We suggest that SII could be monitored to guide prognostication and provide reliable information on the risk of disease progression in GC.

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Clinical significance of fucosylated GP73 in the differential diagnosis of hepatocellular carcinoma

The International Journal of Biological Markers ◽

10.1177/1724600818796646 ◽

2018 ◽

Vol 33 (4) ◽

pp. 439-446 ◽

Cited By ~ 5

Author(s):

Yunsheng Zhao ◽

Lina Zhang ◽

Lijing Huo ◽

Liu Pei ◽

Qiuping Li ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Differential Diagnosis ◽

Roc Curve ◽

Enzyme Linked Immunosorbent Assay ◽

Diagnostic Efficiency ◽

Roc Curve Analysis ◽

Diagnostic Significance ◽

Node Metastasis ◽

Tumor Node Metastasis Stage ◽

Normal Controls

Objective: To investigate the clinical value of fucosylated GP73 (Fuc-GP73) levels for differential diagnosis of hepatocellular carcinoma from other liver diseases. Methods: Serum specimens were collected from 50 patients with hepatocellular carcinoma, 60 patients with other digestive system diseases (ODSD), and 40 normal controls. Lectin affinity chromatography column combining with the enzyme-linked immunosorbent assay (ELISA) using the ELISA index was utilized to measure the level of Fuc-GP73. By receiver operating characteristic (ROC) curve analysis its sensitivity and specificity were used to evaluate the diagnostic significance of Fuc-GP73 in hepatocellular carcinoma. Results: The median serum Fuc-GP73 level of hepatocellular carcinoma (20.4 μg/L) was much higher than that of ODSD patients (1.8 μg/L) and the normal controls group (0.3 μg/L), significantly ( P <0.01). There was no significant correlation between serum Fuc-GP73 level and sex, age, and tumor size in the hepatocellular carcinoma group ( P > 0.05); however, it was related to tumor, node, metastasis stage and lymph node metastasis ( P <0.05). The area under the ROC curve (AUC) of Fuc-GP73 to detect hepatocellular carcinoma alone was 0.885; with the prespecified specificity of 95%, the sensitivity and the cutoff value were 82% and 3.1 μg/L. In addition, the combined test of Fuc-GP73 with other biomarkers can improve the clinical diagnostic efficiency; the AUC can reach to 0.983; and with the prespecified specificity of 95% its sensitivity increased to 94%. Conclusion: Fuc-GP73 can act as a superior glycobiomarker for the differential diagnosis of hepatocellular carcinoma; its combined detection with other biomarkers can improve diagnostic accuracy.

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Case Report: Gastric Cancer Combined With Bilateral Ovarian Metastasis In Pregnancy

10.21203/rs.3.rs-871687/v1 ◽

2021 ◽

Author(s):

Zhenhua Zhang ◽

Gang Lv ◽

Mei Liu ◽

Miaohui Lin ◽

Meilin Xie ◽

...

Keyword(s):

Gastric Cancer ◽

Case Report ◽

Early Diagnosis ◽

Malignant Tumors ◽

Ovarian Metastasis ◽

Ovarian Mass ◽

Health Checkup ◽

Case Presentation ◽

Treatment Plans ◽

In Pregnancy

Abstract Background: The early manifestations of gastric cancer during pregnancy are non-specific. Ovarian mass and ascites are the main manifestations of late ovarian metastasis. Case presentation: A case of late gastric cancer with bilateral ovarian metastasis in pregnancy was reported in our study. Cesarean section and full staging of ovarian malignant tumors were performed at 28+5 weeks of pregnancy, and the prognosis was poor. We performed Cesarean delivery and extracted a vital male newborn of 35 cm, 1020 g, Ap score 3. The newborn is alive and grows normally. Three months later the mother died. The key to improving the prognosis is early diagnosis, and the pre-pregnancy health checkup must be emphasized. Conclusions: During pregnancy, ultrasound, gastroscopy, MRI and other related examinations should be performed to confirm the diagnosis, and individualized treatment plans should be formulated to maximize the protection of the mother and child's interests.

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Serum hsa_tsr016141 as a Kind of tRNA-Derived Fragments Is a Novel Biomarker in Gastric Cancer

Frontiers in Oncology ◽

10.3389/fonc.2021.679366 ◽

2021 ◽

Vol 11 ◽

Author(s):

Xinliang Gu ◽

Shuo Ma ◽

Bo Liang ◽

Shaoqing Ju

Keyword(s):

Gastric Cancer ◽

Sensitivity And Specificity ◽

Small Rnas ◽

Malignant Tumors ◽

Tumor Grade ◽

Expression Level ◽

Dynamic Monitoring ◽

Molecular Characteristics ◽

Diagnostic Efficiency ◽

Healthy Donors

BackgroundGastric cancer (GC) is one of the most common malignant tumors globally and the third leading cause of cancer-related death. Currently, the sensitivity and specificity of diagnostic markers for GC are low, so it is urgent to find new biomarkers with higher sensitivity and specificity. tRNA-derived small RNAs are a kind of small non-coding RNAs derived from tRNAs. It is abundant in cancer cells and body fluids. Our goal is to find the differentially expressed tRNA-derived small RNAs in GC to explore their potential as a GC biomarker.MethodsQuantitative real-time PCR was used to detect the expression level of hsa_tsr016141. The molecular characteristics of hsa_tsr016141 were verified by agarose gel electrophoresis, Sanger sequencing, Actinomycin D Assay, and Nuclear and Cytoplasmic RNA Separation Assay. The diagnostic efficiency of hsa_tsr016141 was analyzed through receiver operating characteristic.ResultsThe expression level of hsa_tsr016141 in GC tissues and serum was significantly increased. The serum expression level showed a gradient change between GC patients, gastritis patients, and healthy donors and was positively correlated with the degree of lymph node metastasis and tumor grade. ROC analysis showed that the serum expression level of hsa_tsr016141 could significantly distinguish GC patients from healthy donors or gastritis patients. Besides, the expression level of hsa_tsr016141 in GC patients decreased significantly after the operation (P<0.0001).ConclusionsSerum hsa_tsr016141 has good stability and specificity and can be used for dynamic monitoring of GC patients, suggesting that serum hsa_tsr016141 can be a novel biomarker for GC diagnosis and postoperative monitoring.

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The risk of lymph node metastasis in gastric cancer conforming to indications of endoscopic resection and pylorus-preserving gastrectomy: a single-center retrospective study

BMC Cancer ◽

10.1186/s12885-021-09008-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wu Yanzhang ◽

Li Guanghua ◽

Zhou Zhihao ◽

Wang Zhixiong ◽

Wang Zhao

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Endoscopic Resection ◽

Survival Rates ◽

Area Under The Curve ◽

Disease Free Survival ◽

Treatment Decision ◽

Node Metastasis ◽

Metastasis Rate

Abstract Background Lymph node metastasis (LNM) status is an important prognostic factor that strongly influences the treatment decision of early gastric cancer (EGC). This study aimed to evaluate the pattern and clinical significance of LNM in EGC. Methods A total of 354 patients with carcinoma in situ (n = 42), EGC (n = 312) who underwent radical gastrectomy were enrolled. Their clinicopathological features, pathological reports, and prognostic data were collected and analyzed. Results The incidence of LNM in all patients was 18.36% (65/354). The rates of D1 and D2 station metastases were 12.10% (43/354) and 6.21% (22/354), respectively. The rates of LNM in absolute indication of endoscopic resection and expanded indication were 3.27% (2/61) and 28.55% (4/14), respectively. Skip LNM was observed in 3.67% (13/354) of patients. For those with middle-third tumor, the metastasis rate of the No. 5 lymph node was 3.05% (5/164). The independent risk factors for LNM were tumors measuring > 30 mm, poorly differentiated tumors, and lymphovascular invasion (all P < 0.05; area under the curve, 0.783). The 5-year disease-free survival rates of patients with and without LNM were 96.26 and 79.17%, respectively (P = 0.011). Tumors measuring > 20 mm and LNM were independent predictive factors for poor survival outcome in all patients. Conclusions Patients with EGC conforming to expanded indications have a relatively high risk of LNM and may not be suitable for endoscopic submucosal dissection. Pylorus-preserving gastrectomy for patients with middle-third EGC remains controversial due to the high metastasis rate of the No. 5 lymph node.

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Lymphocyte-to-C-reactive protein ratio and score are clinically feasible biomarkers in gastric cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.4_suppl.48 ◽

2019 ◽

Vol 37 (4_suppl) ◽

pp. 48-48 ◽

Cited By ~ 1

Author(s):

Yoshinaga Okugawa ◽

Yuji Toiyama ◽

Akira Yamamoto ◽

Tsunehiko Shigemori ◽

Kurando Kusunoki ◽

...

Keyword(s):

Gastric Cancer ◽

Scoring System ◽

Prognostic Impact ◽

C Reactive Protein ◽

Term Outcome ◽

Long Term Outcome ◽

Reactive Protein ◽

Node Metastasis ◽

Tumor Node Metastasis Stage

48 Background: Systemic inflammation arising from complex host-tumor interactions is considered the seventh hallmark of cancer. The aim of this retrospective study was to assess the clinical feasibility of our newly developed ‘lymphocyte-to-C-reactive protein (CRP) ratio’ (LCR) and ‘lymphocyte CRP score’ (LCS) for predicting short- and long-term outcomes in patients with gastric cancer. Methods: In total, 551 patients who underwent gastrectomy for primary gastric cancer at our institution were enrolled in this study. Preoperative LCR was calculated as follows: lymphocyte count (number/µL)/CRP level (mg/dL), and scoring system (LCS) was devised based on the cut-off value of both lymphocytes (1 × 109/L) and CRP (0.3 mg/dL) from previous evidences. Results: Reduced pre-operative LCRs significantly correlated with all of the well-established clinicopathological factors for disease development, including advanced T stage, venous invasion, lymphatic vessel invasion, lymph node metastasis hepatic metastasis, peritoneal metastasis, distant metastasis, and advanced tumor-node-metastasis stage. In the short-term outcome, low pre-operative LCR was an independent predictive factor for post-operative surgical site infection (SSI: OR:1.82, 95.0% CI:1.06–3.12, P = 0.03). In the long-term outcome, low pre-operative LCR was an independent prognostic factor for disease-free survival (DFS: HR:1.53, 95.0% CI:1.01–2.32, P = 0.04) and overall survival (OS: HR:2.03, 95.0% CI:1.42–2.90, P < 0.001), and prognostic impact of pre-operative LCR were verified in patients with metastatic and non-metastatic gastric cancer using the same cut-off value. Furthermore, our developed scoring system using lymphocyte and CRP could also demonstrated all of clinical significance using same difinite cut-off value in GC patients (SSI: OR: 4.43, 95.0% CI:1.75–11.2, P = 0.002; DFS: HR: 3.82, 95.0% CI:1.81–8.06, P < 0.001; OS: HR:2.88, 95.0% CI:1.48–5.61, P = 0.002). Conclusions: Assessment of lymphocytes and CRP could aid physicians in determining surgical risk, and oncological risk, thus faciliating appropriate peri-operative and post-operative management of patients with gastric cancer.

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Elucidating the Role of Serum tRF-31-U5YKFN8DYDZDD as a Novel Diagnostic Biomarker in Gastric Cancer (GC)

Frontiers in Oncology ◽

10.3389/fonc.2021.723753 ◽

2021 ◽

Vol 11 ◽

Author(s):

Yuejiao Huang ◽

Haiyan Zhang ◽

Xinliang Gu ◽

Shiyi Qin ◽

Ming Zheng ◽

...

Keyword(s):

Gastric Cancer ◽

Roc Curve ◽

Small Rnas ◽

High Throughput Sequencing ◽

Detection Efficiency ◽

Malignant Tumors ◽

Biological Significance ◽

Tumor Biomarker ◽

Diagnostic Biomarker ◽

Roc Curve Analysis

BackgroundGastric cancer (GC) is one of the malignant tumors with the highest morbidity and mortality in the world. Early diagnosis combined with surgical treatment can significantly improve the prognosis of patients. Therefore, it is urgent to seek higher sensitivity and specificity biomarkers in GC. tRNA-derived small RNAs are a new non-coding small RNA that widely exists in tumor cells and body fluids. In this study, we explore the expression and biological significance of tRNA-derived small RNAs in GC.Materials and MethodsFirst of all, we screened the differentially expressed tRNA-derived small RNAs in tumor tissues by high-throughput sequencing. Agarose gel electrophoresis (AGE), Sanger sequencing, and Nuclear and Cytoplasmic RNA Separation Assay were used to screen tRF-31-U5YKFN8DYDZDD as a potential tumor biomarker for the diagnosis of GC. Then, we detected the different expressions of tRF-31-U5YKFN8DYDZDD in 24 pairs of GC and paracancerous tissues, the serum of 111 GC patients at first diagnosis, 89 normal subjects, 48 superficial gastritis patients, and 28 postoperative GC patients by quantitative real-time PCR (qRT-PCR). Finally, we used the receiver operating characteristic (ROC) curve to analyze its diagnostic efficacy.ResultsThe expression of tRF-31-U5YKFN8DYDZDD has good stability and easy detection. tRF-31-U5YKFN8DYDZDD was highly expressed in tumor tissue, serum, and cell lines of GC, and the expression was significantly related to TNM stage, depth of tumor invasion, lymph node metastasis, and vascular invasion. The expression of serum tRF-31-U5YKFN8DYDZDD in the GC patients decreased after the operation (P = 0.0003). Combined with ROC curve analysis, tRF-31-U5YKFN8DYDZDD has better detection efficiency than conventional markers.ConclusionsThe expressions of tRF-31-U5YKFN8DYDZDD in the tumor and paracancerous tissues, the serum of GC patients and healthy people, and the serum of GC patients before and after operation were different. tRF-31-U5YKFN8DYDZDD is not only a diagnostic biomarker of GC but also a predictor of poor prognosis.

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Diagnostic Value of Albumin to Fibrinogen Ratio in Cervical Cancer

The International Journal of Biological Markers ◽

10.1177/1724600820915916 ◽

2020 ◽

Vol 35 (2) ◽

pp. 66-73 ◽

Cited By ~ 1

Author(s):

Li Huang ◽

Zhuning Mo ◽

Linyan Zhang ◽

Shanzi Qin ◽

Simeng Qin ◽

...

Keyword(s):

Cervical Cancer ◽

Operating Characteristic ◽

Malignant Tumors ◽

Area Under The Curve ◽

Intraepithelial Neoplasia ◽

Tumor Stage ◽

Diagnostic Value ◽

Ca 125 ◽

Diagnostic Efficiency ◽

Cancer Antigen 125

Background: Albumin to fibrinogen ratio (AFR) play a crucial role in the progression and prognosis of many malignant tumors. This study aimed to comprehensively assess the diagnostic value of AFR as single markers or in combination with squamous cell carcinoma antigen (SCC-Ag), cancer antigen 125 (CA-125) in cervical cancer. Methods: A total of 323 cervical cancer inpatients, 143 patients with cervical intraepithelial neoplasia (CIN) and 317 healthy controls were analyzed. Differences in laboratory parameters and clinicopathological features were calculated using the Mann–Whitney U or Kruskal–Wallis H test. The receiver operating characteristic (ROC) curve was used to evaluate the predicted value of AFR, alone or combined with SCC-Ag, CA-125 for the diagnosis of cervical cancer. Results: The levels of AFR in patients with cervical cancer were significantly lower than those in the CIN patients and the control subjects. AFR were not only negatively correlated with the tumor stage, but also related to histology typing, lymph node metastasis, distant metastasis, depth of stromal infiltration, tumor size, and tumor stage; however, it was not associated with the blood group. AFR combined with SCC-Ag possessed a larger area under the curve (AUC; AUCAFR+SCC-Ag = 0.924, 95% confidence interval (CI) 0.900, 0.944) than AFR ( P < 0.001), SCC-Ag ( P < 0.001), or CA-125 ( P < 0.001) did alone. Conclusions: The pretreatment levels of AFR, alone or combined with SCC-Ag, CA-125 could improve the diagnostic efficiency of cervical cancer.

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Circulating Exosomal miR-17-92 Cluster Serves as a Novel Non-Invasive Diagnostic Marker for Gastric Cancer Patients

10.21203/rs.3.rs-826985/v1 ◽

2021 ◽

Author(s):

Fei Liu ◽

Ye Han ◽

Dongbao Li ◽

Jun Zhou ◽

Jingjing Xu ◽

...

Keyword(s):

Gastric Cancer ◽

Malignant Tumors ◽

Quantitative Polymerase Chain Reaction ◽

Characteristic Curve ◽

Diagnostic Value ◽

Diagnostic Efficiency ◽

Roc Curve Analysis ◽

Non Invasive ◽

Clinical Diagnostic ◽

Potential Biomarker

Abstract Gastric cancer (GC) is one of the most common malignant tumors with a leading cause of cancer-related mortality worldwide. Exosomal miRNAs are considered as promising non-invasive biomarkers for the diagnosis of malignant tumors. In this study, we aimed to investigate the expression of exosomal miR-17-92 cluster and develop a potential biomarker for the diagnosis of GC. Exosomal RNAs were extracted and the expression profile of miR-17-92 cluster was detected using quantitative polymerase chain reaction (qRT-PCR). The ROC (receiver-operating characteristic) curve and AUC (area under the ROC curve) analysis were used to explore the diagnostic utility of miRNAs. Statistical was used to analyze the expression of serum exosomal miR-17-92 cluster with the clinical pathological parameters of GC patients. The results showed that the expressions of four members of the exosomal miR-17-92 cluster in the serum samples of GC patients were significantly upregulated compared with those of healthy controls. The AUC for serum exosomal miR-17, miR-18, miR-19a and miR-92 was 0.750 (95%CI=0.626-0.874, sensitivity=84.7%, specificity=70.0%), 0.736 (95%CI=0.590-0.881, sensitivity=88.9%, specificity=65.0%), 0.700 (95%CI=0.562-0.838, sensitivity=62.5%, specificity=80.0%), 0.689 (95%CI=0.567-0.811, sensitivity=45.8%, specificity=90.0%), respectively. The AUC for the newly combined panel consisting of miR-17, miR-18, miR-19a and miR-92 was 0.808 (95%CI=0.680-0.937), with sensitivity of 90.3% and specificity of 70.0%, which showed much higher clinical diagnostic value for GC than any of the four alone or any pair. Besides, the AUC for the newly developed panel consisting of the two traditional tumor biomarkers including CEA (carcinoembryonic antigen) and CA19-9 (carbohydrate antigen 19-9) and the four miR-17-92 cluster members was 0.881 (95%CI, 0.765-0.998) with sensitivity of 91.7% and specificity of 90.0%, which showed the greatest powerful clinical diagnostic value for GC. Moreover, the elevated exosomal miR-17-92 expressions were closely correlated with tumor size, tumor depth, lymph node metastasis, distant metastasis and TNM stage of GC patients. In conclusion, our findings revealed that circulating exosomal miR-17-92 cluster may be used as a novel potential non-invasive biomarker to improve the diagnostic efficiency in GC.

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