Evaluation of the Role of Circulating Long Non‐Coding RNA H19 as a Promising Novel Biomarker in Plasma of Patients with Gastric Cancer

Background H19 is one of the long non‐coding RNA s (Lnc RNA ) that is related to the progression of many diseases including cancers. This work was carried out to study the level of the long non‐coding RNA ; H19 , in plasma of patients with gastric cancer ( GC ) and to assess its significance in their clinical management. Methods Sixty‐two participants were enrolled in the present study. The first group included 32 GC patients. The second group was formed of 30 age and sex matched healthy volunteers serving as a control group. Plasma samples were used to assess H19 gene expression using real‐time quantitative PCR technique. Results H19 expression was up‐regulated and closely related to TNM cancer stages in GC patients. Using Receiver Operating Characteristic ( ROC ) curve analysis, a cutoff level of 0.5 was set for H19 expression to diagnose GC cases achieving a sensitivity of 68.75%, specificity of 56.67%, positive predictive value ( PPV ) 62.86% and negative predictive value ( NPV ) 62.96% with an area under the curve ( AUC ) of 72.4%. Combined use of Carcinoembryonic Antigen ( CEA ) and H19 level in GC diagnosis was evaluated using ROC curve revealing improvement in performance with an area under the curve of 80.4%. Conclusions Up‐regulation of H19 is closely associated with gastric cancer displaying progressive up‐regulation in advanced stages of the disease implementing its role as a potential non‐invasive diagnostic biomarker in gastric cancer and as a novel tool in gastric cancer management with better performance achieved on using both CEA and H19 simultaneously.