Tsai Ming-Ming, Wang Chia-Siu, Tsai Chung-Ying, Huang Hsiang-Wei, Chi Hsiang-Cheng, Lin Yang-Hsiang, Lu Pei-Hsuan, Lin Kwang-Huei
Department of Nursing, Chang-Gung University of Science and Technology, Taoyuan 333, Taiwan.
Department of General Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan.
Int J Mol Sci. 2016 Jun 16;17(6):945. doi: 10.3390/ijms17060945.
Human gastric cancer (GC) is characterized by a high incidence and mortality rate, largely because it is normally not identified until a relatively advanced stage owing to a lack of early diagnostic biomarkers. Gastroscopy with biopsy is the routine method for screening, and gastrectomy is the major therapeutic strategy for GC. However, in more than 30% of GC surgical patients, cancer has progressed too far for effective medical resection. Thus, useful biomarkers for early screening or detection of GC are essential for improving patients' survival rate. MicroRNAs (miRNAs) play an important role in tumorigenesis. They contribute to gastric carcinogenesis by altering the expression of oncogenes and tumor suppressors. Because of their stability in tissues, serum/plasma and other body fluids, miRNAs have been suggested as novel tumor biomarkers with suitable clinical potential. Recently, aberrantly expressed miRNAs have been identified and tested for clinical application in the management of GC. Aberrant miRNA expression profiles determined with miRNA microarrays, quantitative reverse transcription-polymerase chain reaction and next-generation sequencing approaches could be used to establish sample specificity and to identify tumor type. Here, we provide an up-to-date summary of tissue-based GC-associated miRNAs, describing their involvement and that of their downstream targets in tumorigenic and biological processes. We examine correlations among significant clinical parameters and prognostic indicators, and discuss recurrence monitoring and therapeutic options in GC. We also review plasma/serum-based, GC-associated, circulating miRNAs and their clinical applications, focusing especially on early diagnosis. By providing insights into the mechanisms of miRNA-related tumor progression, this review will hopefully aid in the identification of novel potential therapeutic targets.
人类胃癌(GC)的特点是发病率和死亡率高,这主要是因为由于缺乏早期诊断生物标志物,通常直到相对晚期才被发现。胃镜检查及活检是筛查的常规方法,胃切除术是GC的主要治疗策略。然而,在超过30%的GC手术患者中,癌症进展过快,无法进行有效的手术切除。因此,用于早期筛查或检测GC的有用生物标志物对于提高患者生存率至关重要。微小RNA(miRNA)在肿瘤发生中起重要作用。它们通过改变癌基因和肿瘤抑制因子的表达来促进胃癌发生。由于miRNA在组织、血清/血浆和其他体液中具有稳定性,因此被认为是具有合适临床潜力的新型肿瘤生物标志物。最近,已鉴定出异常表达的miRNA并在GC管理的临床应用中进行了测试。通过miRNA微阵列、定量逆转录-聚合酶链反应和下一代测序方法确定的异常miRNA表达谱可用于建立样本特异性并识别肿瘤类型。在这里,我们提供了基于组织的GC相关miRNA的最新综述,描述了它们及其下游靶点在致瘤和生物学过程中的参与情况。我们研究了重要临床参数和预后指标之间的相关性,并讨论了GC中的复发监测和治疗选择。我们还综述了基于血浆/血清的、GC相关的循环miRNA及其临床应用,尤其关注早期诊断。通过深入了解miRNA相关肿瘤进展的机制,本综述有望有助于识别新的潜在治疗靶点。