Backgrounds Due to difficulty in early diagnosis of chronic pancreatitis (CP), it is urgent to find novel biomarkers to detect CP. Exosomal microRNAs (Exo-miRNAs) located in the serum may be potential diagnostic and therapeutic targets for CP. In our study, we performed a bioinformatics analysis to identify differentially expressed Exo-miRNAs (DE-Exo-miRNAs) in the serum of CP patients. Methods The dataset GSE128508 was downloaded from the Gene Expression Omnibus (GEO) database. The analysis was carried out using BRB-ArrayTools and Significance Analysis of Microarrays (SAM). The target genes of DE-S-Exo-miRNAs were predicted by miRWalk databases. Further gene ontology (GO) term and Kyoto Encyclopedia of Genomes (KEGG) pathway analyses were performed with plug-in ClueGO in Cytoscape software 3.7.0. Subsequently, the interaction regulatory network between encoded proteins of target genes was performed with the Search Tool for the Retrieval of Interacting Genes (STRING) database and analyzed using plug-in MCODE and cytoHubba in Cytoscape software 3.7.0. Results We identified 227 DE-Exo-miRNAs in the serum. Further analysis using the miRWalk database identified 5164 target genes of these miRNAs. The protein-protein interaction (PPI) regulatory network of 1912 potential target genes for hub 10 up-regulated miRNAs with high degrees and one down-regulated miRNAs were constructed using the STRING database and Cytoscape software. The functional analysis using Cytoscape software tool highlighted that target genes involved in pancreatic cancer. Acinar-ductal metaplasia (ADM) in the inflammatory environment of CP is a precursor of pancreatic cancer. Subsequently, we constructed a network of target genes associated with ADM and their miRNAs. Conclusions Exo-miRNAs in the serum as well as their target genes may be promising targets for the early diagnosis and treatment of CP. In addition, we identified potential Exo-miRNAs involved in ADM that is a precursor of pancreatic cancer associated with CP.
Background: The efficacy of endoscopic ultrasound (EUS) for determining T category is variable for gastric cancer. The aim of this study is to evaluate the superiority of EUS by using the 6th edition American Joint Committee on Cancer (AJCC) staging system for stomach cancer compared to the new 7th/8th edition.Methods: A retrospective analysis of clinical and EUS imaging features of 348 gastric carcinoma patients who underwent radical resection were collected. Differences between the 6th edition and 7th/8th edition T staging system for EUS preoperative evaluated were compared.Results: The accuracy of EUS T staging was 72.4% for 7th/8th edition and 78.4% for 6th edition; especially the T3 stage accuracy was significantly worse when T3 group status was changed. The tumor location, EUS type and histological type were associated with inaccuracy. We further analyzed the EUS image features for each tumor T stage and found muscularis propria (MP) visible indistinctly or obvious thickening were considered to be indicators that lesions involved to the MP with a sensitivity of 81.3%; MP disappeared completely and accompanied with serosal layer intact might be a marker that lesion invaded to the subserosa; We also found that irregularities in the outer edge of the gastric wall were markers of gastric serosal layer penetration with a positive predictive value of 92.2%.Conclusions: The increased complexity of the 7th/8th edition T staging system is accompanied by worsening in the predictive accuracy for EUS as compared to the 6th edition. Furthermore, the tumor location, EUS type, histological type and EUS image features for each tumor T stage should warrant attention.
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