Abstract: Objective To investigate the clinical value of serum exosome hsa_circ_0008035 in early gastric cancer (GC) and premalignant gastric lesions (Pre).Methods The peripheral blood samples of 90 GC patients (GC group) and 89 premalignant gastric lesions (Pre group) who visited our hospital from January 2012 to December 2017 were collected.At the same time,45 healthy volunteers were included as the control group (NC group).And quantitative real-time fluorescence polymerase chain reaction (qRT-PCR) was used to detect serum exosomal hsa_circ_0008035 Horizontal.Receiver operating characteristic (ROC) curve was drew to evaluate serum exosomal hsa_circ_0008035.Follow up the disease progression of Pre group patients through endoscopic examination.Finally,Based on circBase and RegRNA 2.0 target prediction software to seek the potential microRNA (miRNA) targets of hsa_circ_0008035.Results Compared with NC group,the expression level of serum exosomal hsa_circ_0008035 in GC group or Pre group were significantly increased,with the most pronounced increase in the GC group (P＜0.05).Compared with traditional tumor markers detection,the area under curve (AUC),sensitivity and accuracy of exosomal hsa_circ_0008035 in the diagnosis of GC and Pre were significantly increased,and the false negative rate and false positive rate were significantly decreased (P＜0.05).The AUC was 0.681 ,a sensitivity and specificity were 66.35% and 83.31% of exosomal hsa_circ_0008035 in distinguishing between patients with early GC and Pre.For the Pre group patients,a median follow-up of 5.3 years was observed,during which 21 patients experienced disease progression.These patients were diagnosed with a significant increase in serum exosome hsa_circ_0008035 expression level compared to baseline (P＜0.001).Moreover,the serum exosome hsa_circ_0008035 expression level at baseline was generally higher than that of patients without disease progression (P=0.005).For patients in the GC group,the expression level of serum exosomal hsa_circ_0008035 in patients with middle and advanced GC (TNM stage Ⅲ-Ⅳ) was higher than that in patients with early GC (P＜0.05).Hsa_circ_0008035 target pathway prediction results showed that hsa_circ_0008035 contained hsa-miR-599,hsa-miR-17-3p,hsa-miR-1256 and hsa-miR-375 seed sequences and related common downstream targets.Conclusion The expression of serum exosomal hsa_circ_0008035 is generally increased in the patients with early GC and premalignant gastric lesions,which has has certain clinical significance for the diagnosis of early GC and premalignant gastric lesions,and evaluation of disease progression.

Key words: gastric cancer; premalignant gastric lesions; early diagnosis; hsa_circ_0008035