Published online Jun 14, 2020. doi: 10.3748/wjg.v26.i22.3024
Peer-review started: December 28, 2019
First decision: January 19, 2020
Revised: May 14, 2020
Accepted: May 28, 2020
Article in press: May 28, 2020
Published online: June 14, 2020
Despite the major advances in the field of personalized medicine, gastric cancer (GC) remains an aggressive malignancy with a high rate of mortality, being the third leading cause of cancer-related death. The main issue in the management of this disease is represented by the high molecular heterogeneity that results in the phenotypical aggressiveness of GC and limits the antitumor efficacy of the targeted therapy.
GC is still characterized by late diagnosis, limited effective treatment options, and lack of reliable biomarkers for the patient outcome prediction and response to therapy. The discovery of new circulating biomarkers useful in the early diagnosis of GC is mandatory.
The present study aimed to evaluate the potential of COL10A1 as a circulating biomarker for the diagnosis and prognosis of gastric adenocarcinoma patients.
Plasma and tissue samples obtained from 49 patients with gastric adenocarcinoma have been used in exploring the expression of COL10A1. Real-time PCR and western blot techniques were used to evaluate COL10A1 level in gastric tumor tissue compared to normal adjacent tissue. The circulating level of COL10A1 was also evaluated by ELISA in plasma of gastric adenocarcinoma patients. Survival analysis was made in order to evaluate the potential of COL10A1 as a biomarker for the diagnosis and prognosis of gastric adenocarcinoma patients.
Our results showed a significant increase in COL10A1 gene expression and protein levels in gastric tumor tissue compared to adjacent normal tissue. COL10A1 seems to show an elevated expression from the beginning of carcinogenesis, in the early stages, and its increased level remains elevated during cancer progression. This significant increase of COL10A1 was observed also in plasma of gastric adenocarcinoma patients. Moreover, increased COL10A1 plasma level was associated with poor survival. Plasma COL10A1 performed a diagnostic value in GC with an area under the receiver operating characteristic curve (AUC) of 0.9171 (P = 0.0002), sensitivity of 87.76%, and specificity of 100.0%. Furthermore, this study demonstrated the potential role of plasma COL10A1 in the early detection of GC, as in the early stage we obtained an AUC of 0.8789 (P = 0.0030), sensitivity of 81.25%, and specificity of 100.0%. If confirmed in further studies, circulating COL10A1 level could be considered for treatment decisions in these patients.
We reported for the first time an increased circulating expression level of COL10A1 in gastric adenocarcinoma patients that is associated with poor survival. The high sensitivity and specificity obtained suggest that COL10A1 could represent a potential biomarker for early detection of GC.
The identification of circulating biomarkers is important since their detection is non-invasive and can be easily implemented in daily clinical practice without higher costs, being based on such techniques as ELISA. On the other hand, the use of a cheap and specific test for population screening could improve early diagnosis rate and contribute to the decrease of the GC burden.