Affiliations: [a] Department of Digestive System, Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, Shandong, China | [b] Transfusion Centre, Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, Shandong, China
Correspondence:
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Corresponding author: Ming Qi, Department of Digestive System, Jinan Central Hospital Affiliated to Shandong University, Jiefang Road No.105, Jinan 250013, Shandong, China. Tel.: +86 0531 68746224; Fax: +86 0531 68746224; E-mail:mingqi19881020@163.com
Abstract: BACKGROUND: Multidrug resistance in gastric cancer greatly impedes
the efficacy of chemotherapy. OBJECTIVE: To explore the efficacy of microRNA-21 (mir-21) in
distinguishing metastatic gastric cancer (MGC) with chemoresistance. METHODS: From April 2012 to May 2015, 92 MGC patients were
enrolled. Cisplatin and fluorouracil-based systemic chemotherapy was given,
and patients' characteristics and follow-up data were collected. In
addition, miR-21 expression was determined in tumor tissue and plasma. RESULTS: Sixty-seven patients responded to chemotherapy, and chemotherapy
resistance was observed in 25 patients. miR-21 expression in tumor tissue
and plasma was significantly elevated in the chemotherapy-resistant group
(CRG) compared to the chemotherapy-sensitive group (CSG) (p< 0.001). miR-21
expression in tissue was associated with tumor differentiation (p= 0.042),
and plasma miR-21 was correlated with gender (p= 0.016), tumor
differentiation (p= 0.003), and number of metastatic sites (p< 0.001).
Receiver operating characteristic (ROC) analysis indicated that miR-21 in
tissue yielded an area under the ROC curve (AUC) of 0.830 (95%CI:
0.737-0.900, sensitivity: 88.0%, specificity: 68.7%) in distinguishing
CRG from CSG; and plasma miR-21 yielded an AUC of 0.759 (95%CI:
0.658-0.842, sensitivity: 52.0%, specificity: 88.1%) in distinguishing
CRG form CSG. Log-rank test and Cox proportional hazard regression analysis
indicated that patients with higher miR-21 expression in tissue and plasma
experienced shorter overall survival (P< 0.001). CONCLUSION: miR-21 could serve as a potential biomarker to identify
MGC with chemoresistance.
