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Circulating cell-free human telomerase reverse transcriptase mRNA in plasma and its potential diagnostic and prognostic value for gastric cancer

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Abstract

Background

Our aims were to detect circulating cell-free human telomerase reverse transcriptase (hTERT) mRNA in the plasma of gastric cancer patients and evaluate its potential diagnostic and prognostic value.

Methods

Real-time quantitative reverse transcription-polymerase chain reaction was employed to detect circulating cell-free hTERT mRNA from 118 gastric cancer patients, 40 chronic atrophic gastritis (CAG) patients, and 58 healthy controls.

Results

Circulating cell-free hTERT mRNA was detected in all gastric cancer patients, 39 (97.5 %) CAG patients and 56 (96.6 %) healthy control individuals, respectively. However, it was higher in gastric cancer than in CAG and healthy controls (all at P < 0.05). Moreover, its high level was significantly correlated with clinical stages (P < 0.001) and lymph nodes metastasis (P < 0.001). There was no difference between circulating cell-free mRNA and other parameters. The area under the receiver operating characteristic (ROC) curve was 0.891, and the optimal cut-off point was 0.18, providing a sensitivity of 66 % and a specificity of 87 %. The ROC analysis showed that the diagnosis capability of circulating cell-free mRNA was statistically significantly higher than that of carcinoembryonic antigen (CEA) and cancer antigen 19-9 (CA19-9), alone [CEA (0.656); CA19-9 (0.722)] or in combination (0.756). Kaplan–Meier analysis demonstrated a correlation between increased circulating cell-free hTERT mRNA and reduced disease-free survival (P < 0.001) and overall survival (P < 0.001). Cox analysis indicated that it was an independent prognostic factor for disease-free survival and overall survival.

Conclusions

We concluded that circulating cell-free hTERT mRNA might serve as a potential and useful noninvasive tumor marker for gastric cancer.

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Abbreviations

GC:

Gastric cancer

CEA:

Carcinoembryonic antigen

CA19-9:

Cancer antigen 19-9

CAG:

Chronic atrophic gastritis

AUC:

The area under the ROC curve

ROC:

Receiver operating characteristic

DFS:

Disease-free survival

OS:

Overall survival

hTERT:

Human telomerase reverse transcriptase

C q :

Quantification cycle

RT-qPCR:

Reverse transcription quantitative real-time PCR

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Acknowledgments

Authors thank Dr. Xiaoju Zhang (Department of Anesthesia, University of California, San Francisco) for critically reviewing the manuscript.

Conflict of interest

All the authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Infectious Diseases, Henan Provincial People’s Hospital, 7# Weiwu Road, Zhengzhou, 450003, Henan, People’s Republic of China

    Yi Kang & Jia Shang

  2. Department of Surgery, Henan Provincial People’s Hospital, 7# Weiwu Road, Zhengzhou, 450003, Henan, People’s Republic of China

    Jiancheng Zhang & Peichun Sun

Authors
  1. Yi Kang
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  2. Jiancheng Zhang
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  3. Peichun Sun
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  4. Jia Shang
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Correspondence to Jia Shang.

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Kang, Y., Zhang, J., Sun, P. et al. Circulating cell-free human telomerase reverse transcriptase mRNA in plasma and its potential diagnostic and prognostic value for gastric cancer. Int J Clin Oncol 18, 478–486 (2013). https://doi.org/10.1007/s10147-012-0405-9

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  • DOI: https://doi.org/10.1007/s10147-012-0405-9

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