目的 探析Xα1型胶原蛋白（collagen type X alpha 1，COL10A1）、微小RNA（microRNA，miRNA）-21、miRNA-320c表达水平对胃癌腹膜转移及预后的预测效能。 方法 回顾性分析内蒙古医科大学附属肿瘤医院2023年7月至2024年9月收治的120例胃癌患者的临床资料。治疗后采用门诊及电话随访形式随访患者预后结局，并根据是否发生腹膜转移分为腹膜转移组和无腹膜转移组；根据预后结局分为不良组和良好组。采用酶联免疫法检测COL10A1；采用qRT-PCR检测miRNA-21、miRNA-320c。对比腹膜转移组、无腹膜转移组临床特征、血清COL10A1、miRNA-21、miRNA-320c；对比不同预后胃癌患者血清COL10A1、miRNA-21、miRNA-320c表达水平；采用Cox单因素及多因素对胃癌预后影响因素进行逐步回归分析；采用ROC分析血清COL10A1、miRNA-21、miRNA-320c对胃癌预后的预测效能。 结果 120例胃癌患者中，腹膜转移31例，无腹膜转移89例。腹膜转移组TNM分期高于无腹膜转移组（P < 0.05）。腹膜转移组血清COL10A1、miRNA-21、miRNA-320c均高于无腹膜转移组（P < 0.05）。120例胃癌患者中，不良组42例，良好组78例。不良组血清COL10A1、miRNA-21、miRNA-320c均高于良好组（P < 0.05）。Cox单因素显示，TNM分期、腹膜转移、淋巴结转移、COL10A1、miRNA-21、miRNA-320c与胃癌患者预后相关（均P < 0.05）；多因素显示，TNM分期、腹膜转移、COL10A1、miRNA-21、miRNA-320c是影响胃癌患者预后的独立危险因素（均P < 0.05）。ROC曲线显示，血清COL10A1、miRNA-21、miRNA-320c联合预测胃癌预后结局的灵敏度及特异度分别为89.45%、92.34%，AUC达0.921，高于COL10A1（P = 0.011）、miRNA-21（P = 0.023）及miRNA-320c（P = 0.015）单独诊断。 结论 血清COL10A1、miRNA-21、miRNA-320c在胃癌腹膜转移及不良预后患者中呈高表达水平，且上述指标为胃癌患者不良预后危险因素，联合应用对预后结局有着较高预测效能。

Objective To explore the predictive efficacy of serum expression levels of collagen type X alpha 1 （COL10A1）， microRNA （miRNA）-21， and miRNA-320c in peritoneal metastasis and prognosis of gastric cancer. Methods The clinical data of 120 patients diagnosed with gastric cancer and admitted to our hospital between July 2023 and September 2024 were retrospectively analyzed. Post-treatment， the prognostic outcomes of these patients were tracked through outpatient and telephone follow-up. Based on the occurrence of peritoneal metastasis， the patients were classified into the peritoneal metastasis group and the non-peritoneal metastasis group. According to the prognostic outcomes， they were further divided into the poor prognosis group and the good prognosis group. Enzyme-linked immunosorbent assay （ELISA） was employed to detect the expression of serum COL10A1. Quantitative real-time polymerase chain reaction （qRT-PCR） was utilized to measure the expression levels of miRNA-21 and miRNA-320c. A comparison was made regarding the clinical characteristics， serum levels of COL10A1， miRNA-21， and miRNA-320c between the peritoneal metastasis group and the non-peritoneal metastasis group. Additionally， the serum expression levels of the aforementioned indicators were also compared among gastric cancer patients with different prognostic outcomes. Cox univariate and multivariate stepwise regression analyses were carried out to identify the factors influencing the prognosis of gastric cancer. Receiver operating characteristic （ROC） curve analysis was performed to assess the predictive efficacy of serum COL10A1， miRNA-21， and miRNA-320c for the prognosis of gastric cancer. Results Among the 120 gastric cancer patients， 31 cases presented with peritoneal metastasis while 89 cases did not. The TNM stage of the peritoneal metastasis group was notably higher than that of the non-peritoneal metastasis group （P < 0.05）. The serum expression levels of COL10A1， miRNA-21， and miRNA-320c in the peritoneal metastasis group were all elevated compared to those in the non-peritoneal metastasis group （P < 0.05）. Out of the 120 patients， 42 cases belonged to the poor prognosis group and 78 cases to the good prognosis group. The serum levels of COL10A1， miRNA-21， and miRNA-320c in the poor prognosis group were significantly higher than those in the good prognosis group （P < 0.05）. Cox univariate analysis demonstrated that TNM stage， peritoneal metastasis， lymph node metastasis， serum levels of COL10A1， miRNA-21， and miRNA-320c were all associated with the prognosis of gastric cancer patients （all P < 0.05）； multivariate analysis disclosed that TNM stage， peritoneal metastasis， serum levels of COL10A1， miRNA-21， and miRNA-320c were independent risk factors influencing the prognosis of gastric cancer patients （all P < 0.05）. ROC curve analysis suggested that the combined detection of serum COL10A1， miRNA-21， and miRNA-320c for predicting the prognostic outcomes of gastric cancer had a sensitivity of 89.45% and a specificity of 92.34%， with the area under the curve （AUC） reaching 0.921， which was significantly higher than that of single detection of COL10A1 （P = 0.011）， miRNA-21 （P = 0.023）， and miRNA-320c （P = 0.015）. Conclusion Serum COL10A1， miRNA-21， and miRNA-320c are highly expressed in gastric cancer patients with peritoneal metastasis and poor prognosis. These indicators are independent risk factors for the poor prognosis of gastric cancer patients， and their combined application demonstrates high predictive efficacy for the prognostic outcomes of gastric cancer patients.