血清COL10A1、miRNA-21、miRNA-320c表达水平对胃癌腹膜转移及预后的预测分析

doi:10.3969/j.issn.1006-5725.2026.07.012

Abstract

Abstract:

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.

Key words: gastric cancer, peritoneal metastasis, prognosis, serum COL10A1, miRNA-21, miRNA-320c, predictive efficacy

CLC Number:

R735.2

Fengxue DAI,Zhenfei WANG. Predictive analysis of serum COL10A1， miRNA-21 and miRNA-320c expression levels for peritoneal metastasis and prognosis of gastric cancer[J]. The Journal of Practical Medicine, 2026, 42(7): 1201-1207.

Figures/Tables 6

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References 24

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项目	转移组（n = 31）	未转移组（n = 89）	χ²值	P值
性别			0.657	0.417
女	11（35.48）	39（43.82）
男	20（64.52）	50（56.18）
年龄			1.828	0.176
≥ 60岁	23（74.19）	54（60.67）
< 60岁	8（25.81）	35（39.33）
TNM分期			17.750	0.000
Ⅰ—Ⅱ期	7（22.58）	59（66.29）
Ⅲ—Ⅳ期	24（77.42）	30（33.71）
分化程度			0.000	0.994
低分化	15（48.39）	43（48.31）
中高分化	16（51.61）	46（51.69）
肿瘤位置			0.160	0.923
贲门	7（22.58）	18（20.22）
胃体	15（48.39）	42（47.19）
远端	9（29.03）	29（32.58）

组别	例数	COL10A1/（ng/mL）	miR-21	miR-320c
腹膜转移组	31	6.75 ± 0.95	2.32 ± 0.47	1.59 ± 0.34
无腹膜转移组	89	5.43 ± 0.74	0.59 ± 0.08	0.18 ± 0.02
t值		7.925	33.605	39.239
P值		< 0.001	< 0.001	< 0.001

组别	例数	COL10A1/（ng/mL）	miR-21	miR-320c
不良组	42	7.74 ± 0.59	2.87 ± 0.45	1.87 ± 0.29
良好组	78	5.15 ± 0.49	0.45 ± 0.04	0.15 ± 0.01
t值		25.683	47.319	52.514
P值		< 0.001	< 0.001	< 0.001

临床病理特征	单因素			多因素
临床病理特征	HR	95%CI	P值	HR	95%CI	P值
性别	1.868	1.019 ~ 2.414	0.003	1.554	1.293 ~ 1.883	0.018
年龄	1.418	1.295 ~ 1.730	0.025	1.148	1.023 ~ 1.345	0.056
TNM分期	1.987	1.065 ~ 2.364	< 0.001	1.635	1.355 ~ 2.807	0.011
分化程度	1.418	1.295 ~ 1.730	0.025	1.148	1.023 ~ 1.345	0.056
肿瘤位置	1.019	0.682 ~ 1.523	0.926	-	-	-
腹膜转移	1.794	1.142 ~ 2.821	0.007	1.499	1.314 ~ 1.763	0.023
淋巴结转移	1.152	0.948 ~ 1.506	0.275	-	-	-
COL10A1	1.868	1.019 ~ 2.414	0.003	1.554	1.293 ~ 1.883	0.018
miR-21	2.297	1.166 ~ 3.420	< 0.001	1.830	1.409 ~ 2.302	0.004
miR-320c	2.189	1.409 ~ 3.401	< 0.001	1.801	1.254 ~ 2.633	0.005

指标	AUC	95%CI	Cut-off值	灵敏度/%	特异度/%	约登指数
COL10A1	0.683	0.516 ~ 0.733	6.85 ng/mL	68.75	73.25	0.142
miR-21	0.748	0.657 ~ 0.814	2.14	74.14	75.68	0.150
miR-320c	0.701	0.651 ~ 0.759	1.56	72.35	73.44	0.146
联合检测	0.921^abc	0.811 ~ 0.947	-	89.45	92.34	0.182

Predictive analysis of serum COL10A1， miRNA-21 and miRNA-320c expression levels for peritoneal metastasis and prognosis of gastric cancer

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