Accurate prediction of regional
lymph node metastasis (LNM) in endoscopically resected T1-stage
colorectal cancers (
CRCs) can reduce unnecessary surgeries. To identify
miRNA markers that can predict LNM in T1-stage
CRCs, the study was conducted in two phases; (I)
miRNA classifier construction by
miRNA-array and quantitative reverse transcription PCR (qRT-PCR) using 36 T1-stage CRC samples; (II)
miRNA classifier validation in an independent set of 20 T1-stage CRC samples. The expression of potential downstream target genes of
miRNAs was assessed by immunohistochemistry. In the discovery analysis by
miRNA microarray, expression of 66
miRNAs were significantly different between LNM-positive and negative
CRCs. After qRT-PCR validation, 11
miRNAs were consistently significant in the combined classifier construction set. Among them, miR-342-3p was the most significant one (P=4.3×10-4). Through logistic regression analysis, we developed a three-
miRNA classifier (miR-342-3p, miR-361-3p, and miR-3621) for predicting LNM in T1-stage
CRCs, yielding the area under the curve of 0.947 (94% sensitivity, 85% specificity and 89% accuracy). The discriminative ability of this system was consistently reliable in the independent validation set (83% sensitivity, 64% specificity and 70% of accuracy). Of the potential downstream targets of the three-
miRNAs, expressions of E2F1, RAP2B, and AKT1 were significantly associated with LNM. In conclusion, this classifier can predict LNM more accurately than conventional pathologic criteria and our study results may be helpful to avoid unnecessary bowel surgery after endoscopic resection in early CRC.