Changes of serum FGA,PSA and miR-93-5p,and their predictive effects on lymph node metastasis in elderly patients with early gastric cancer

Wang Yafan; Li Wenju; Zhu Lina

doi:10.3969/j.issn.1672-8521.2025.03.011

Abstract：Objective:To explore changes of serum fibrinogen α chain(FGA),prostrate specific antigen(PSA)and microRNA(miR)-93-5p,and their predictive effect on lymph node metastasis in elderly patients with early gastric cancer.Methods:A total of 106 elderly patients with early gastric cancer in Zhengzhou Renji Hospital from January 2021 to December 2022 were enrolled as the study group.Forty patients with chronic atrophic gastritis treated during the same period in the same hospital were selected as the control group A,and 50 informed volunteers who underwent health examination during the same period in the same hospital were selected as control group B.Serum levels of FGA,PSA and miR-93-5p were compared among the three groups.All patients in the study group received conventional chemotherapy regimens after radical gastrectomy for gastric cancer.After 8 courses of chemotherapy,serum FGA,PSA and miR-93-5p levels were compared before and after chemotherapy regimens after radical gastrectomy for gastric cancer.All patients in the study group were followed up for 12 months,with clinic visits to the hospital for re-examination every 3 months.By the end of the 12th month,the patients were divided into two groups based on the occurrence of lymph node metastasis(metastasis group and non-metastasis group),and the clinicopathological characteristics and serum indexes in the two groups were compared.Receiver operating characteristic(ROC)curve analysis was employed to evaluate the predictive value of serum FGA,PSA and miR-93-5p for lymph node metastasis in early gastric cancer.Multivariate Logistic regression was performed to assess the relationship between these serum biomarkers(FGA,PSA,miR-93-5p)and lymph node metastasis in elderly patients with early gastric cancer.Results:The study group showed significantly higher levels of serum FGA(571.10±85.94 ng/mL),PSA(7.69±2.15 ng/mL),and miR-93-5p(1.93±0.52)compared to control group A(403.81±67.24 ng/mL,4.47±1.03 ng/mL,1.43±0.29)and control group B(319.49±35.71 ng/mL,2.95±0.77 ng/mL,1.10±0.13)(P＜0.001,F=227.367,148.532,213.436,respectively).The study group was higher than the control group A and the control group B(P＜0.05),and the control group A was higher than the control group B(P＜0.05).The levels of serum FGA,PSA and miR-93-5p in the study group before chemotherapy[(571.10±85.94)ng/mL,(7.69±2.15)ng/mL and 1.93±0.52,respectively]were all higher than those after chemotherapy(469.15±62.96 ng/mL,5.45±1.77 ng/mL,1.62±0.31;t=9.853,8.281,5.272;P＜0.001).The non-metastasis group had lower biomarker levels(555.62±58.96 ng/mL,7.28±1.38 ng/mL,1.83±0.38)than the metastasis group(618.73±78.41 ng/mL,8.95±1.77 ng/mL,2.24±0.41;t=4.356,4.988,4.688;P＜0.001).Significant differences existed in clinical stage and differentiation grade(P＜0.05).ROC analysis revealed area under the curve(AUC)of 0.767(FGA),0.826(PSA),0.747(miR-93-5p),and 0.898(combined),(P＜0.001).Logistic regression analysis showed that clinical stage Ⅱ,poorly differentiated degree,FGA＞595.68 ng/mL,PSA＞8.27 ng/mL,and miR-93-5p＞2.08 were independent risk factors for lymph node metastasis in patients with early gastric cancer(P＜0.05).Conclusions:Elderly patients with early gastric cancer demonstrate significant abnormalities in serum levels of FGA,PSA and miR-93-5p.Early detection of these biomarkers shows potential value for predicting lymph node metastasis.