Circulating miR-141 as a potential biomarker for diagnosis, prognosis and therapeutic targets in gallbladder cancer

MicroRNA-141(miR-141) has been reported to play vital roles in the regulation of carcinogenesis and cancer progression. However, the biological function of miR-141 in GBC has received less attention. The aim of this study was to estimate the potential value of the expression level of miR-141 as a diagnostic and prognostic blood-based biomarker in gallbladder cancer (GBC) patients. Meanwhile, to explore its biological role in GBC cells. RT-PCR was employed to confirm the expression of miR-141 in ten paired tissue samples (10 GBC tissues and 10 adjacent normal gallbladder tissues), GBC cell lines and peripheral blood specimens from 98 GBC patients and 60 healthy controls. MTT assay was used to evaluate the GBC cells proliferation and flow cytometry was used to detect the cell apoptosis. Receiver operating characteristic curve analysis and the area under the curve (AUC) were used to evaluate the value of miR-141 plasma levels for GBC diagnosis. Finally, clinicopathological and survival data of all GBC patients were collected and analyzed. Here, we confirmed that the expression of miR-141 were upregulated in primary gallbladder cancer cells and tissues compared with human gallbladder epithelial cells and adjacent normal tissues (P < 0.0001). Meanwhile, we found that downregulated expression of miR-141 by miR-141 inhibitor could induce apoptosis and inhibit proliferation of GBC cells. Additionally, elevated plasma miR-141 expression was also detected in the peripheral blood of GBC patients compared with healthy controls (P < 0.0001). The AUC value of miR-141 for GBC diagnosis was 0.894 (95% CI 0.843-0.945), which was more valuable than those including carcinoembryonic antigen (CEA) (0.713, 95% CI 0.633-0.793), carbohydrate antigen 125 (CA125) (0.837, 95% CI 0.776-0.899) and carbohydrate antigen 19-9 (CA19-9) (0.869, 95% CI 0.813-0.924). The high expression level of miR-141 in plasma was significantly associated with tumor invasion (P = 0.008), lymph node metastasis (P < 0.0001) and advanced pathologic tumor/node/metastasis (pTNM) stage (P = 0.009). More importantly, high plasma miR-141 expression was an independent prognostic factor for predicting poorer long-term survival in GBC patients. Elevated expression of circulating miR-141 in peripheral blood might be a potential novel biomarker for diagnosis and prognosis of GBC patients. Downregulated expression of miR-141 could inhibit proliferation and induce apoptosis of GBC cells, that provide a potential therapeutic target for GBC.

Automated summary

This study aimed to investigate the biological function and diagnostic and prognostic value of miR-141 in gallbladder cancer (GBC). The results showed that miR-141 was highly expressed in GBC cells but lowly expressed in normal tissues. Elevated plasma miR-141 expression was also detected in GBC patients and could serve as a more valuable diagnostic biomarker for GBC. Moreover, high plasma miR-141 expression was closely associated with tumor invasion, lymph node metastasis, and advanced pathological TNM stage, and it was also an independent prognostic factor for predicting poorer survival in GBC patients. These findings suggest that miR-141 may be a potential biomarker for diagnosis, prognosis, and treatment of GBC.