The model demonstrated high sensitivity and specificity in diagnosing patients with GC, especially in differentiating early-stage GC from benign patients. The five miRNA pairs could also aid in making treatment decisions. Thus, miRNAs derived from glycosylated exosomes are promising biomarkers for cancer diagnosis.

GlyExo-capture technology was used to isolate glycosylated extracellular vesicles from serum samples. The signatures were screened in a discovery cohort of GC patients (n=55) and non-disease controls (n=46) using an integrated process, including high-throughput sequencing technology, screening using a complete bioinformatics algorithm, validation using RT-qPCR, and evaluation by constructing a diagnostic model. The diagnostic model was evaluated in an independent validation cohort (n=139).

We developed a diagnostic model for GC based on five miRNA pairs. This diagnostic model demonstrated high sensitivity, specificity, and stable performance in distinguishing GC patients from non-cancer controls with AUC of 0.930 in the independent validation cohort, particularly in differentiating early-stage GC from benign patients. The markers also showed excellent performance in indicating perineural invasion status and lymph node metastasis in the testing cohort.