"Now we have a very simple, inexpensive and non-invasive blood test that can be used for early detection of gastric cancer. We can use this assay along with endoscopy and other diagnostic modalities we currently use in the clinic to improve their diagnostic accuracy, which will lead to improved cancer detection and increased participation from patients and family members who are at-risk for such cancers," the study's senior author Dr. Ajay Goel of the Beckman Research Institute of City of Hope, in Monrovia, California, told Reuters Health by email.
The findings were published in JAMA Network Open.
In four phases, Dr. Goel and colleagues identified a pool of candidate micro-RNA linked to gastric cancer, then progressively cut the number down to three highly accurate biomarkers: miR-18a, miR-181b, and miR-335. These biomarkers diagnosed gastric cancer in every stage with an area under the curve of 86%.
These new miRNA biomarkers appear more accurate at early detection than the non-invasive liquid assays for stomach cancer in clinical use now, the research suggests. Serum tests that detect carcinoembryonic antigen and cancer antigen 19-9 are more useful for later stages of stomach cancer, but the compounds are not easy to detect in patients with early gastric cancer.
By contrast, the new miRNA biomarkers appear to accurately diagnose stage-one stomach cancer with an AUC of 85%.
In the first phase of their research, Dr. Goel and colleagues employed artificial-intelligence tools to analyze genome-wide expression data from nearly 600 tissue samples, comparing healthy tissue to cancer tissue. The effort identified and validated 10 miRNAs linked to gastric cancer.
The second phase validated the expression levels of the 10 miRNAs in healthy and diseased tissue samples. In the third and fourth phases, statistical modelling of data from serum samples reduced the number of biomarkers needed for diagnosis to five and then three.
"These markers will need additional validation in prospective clinical trials, and once confirmed, these can be easily adapted into clinical settings without further delay - possibly in the next three to five years," Dr. Goel said.
Future blood tests based on these biomarkers may be cheaper than endoscopy. The researchers included a cost analysis that found that their blood test could have an incremental cost-effectiveness ratio of US$2,304 per quality-adjusted life-year.
"This is the future of oncological care of our patients," Dr. Goel said. "Such tests are affordable, can be easily done in any clinic and will increase patient compliance."
The study did not have commercial funding.
SOURCE: https://bit.ly/2WHNQ6l JAMA Network Open, online August 24, 2021.
By Rob Goodier
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