Serum miR-638 Combined with Squamous Cell Carcinoma-Related Antigen as Potential Screening Biomarkers for Cervical Squamous Cell Carcinoma

Abstract

<b><i>Aims:</i></b> Cervical cancer is the second most common cause of cancer-related deaths in developing nations. Human papillomavirus prophylactic vaccines are not widely available, and there are shortages of gynecologists and cytologists in the already overburdened health care systems. The aim of this study was to identify circulating microRNAs (miRNAs) that could be used as feasible screening tests for cervical cancer in low-resource regions. <b><i>Materials and Methods:</i></b> Serum expression levels of five miRNAs were measured and validated by quantitative real-time polymerase chain reaction in cervical squamous cell carcinoma (CSCC) patients, cervical intraepithelial neoplasia patients, and healthy individuals. Squamous cell carcinoma-related antigen (SCC-Ag) was also measured in the serum. <b><i>Results:</i></b> Serum <i>miR-638</i>, <i>miR-203a-3p</i>, <i>miR-1914-5p</i>, and <i>miR-521</i> levels were downregulated in the CSCC group (<i>p</i> < 0.05). Receiver operating characteristic (ROC) curve analysis indicated that the area under the ROC curve (AUC) values for <i>miR-638</i> and <i>miR-521</i> were 0.734 and 0.742, respectively, for discriminating CSCC patients from healthy controls. Furthermore, the combined use of <i>miR-638</i> and SCC-Ag yielded the best screening performance and increased the AUC value, sensitivity, and specificity to 0.956, 94.87%, and 80.00%, respectively. <b><i>Conclusion:</i></b> This study suggested that <i>miR-638</i> and <i>miR-521</i> have independent screening value and that the combined measurement of <i>miR-638</i> and SCC-Ag resulted in a better ability to discriminate patients with CSCC from healthy individuals.