MicroRNAs can regulate the transcription of protein-coding genes associated with the development and progression of cancer. In this study, we explored the potential diagnostic function of exosome miR-3184-5p in gastric cancer. This exosome was isolated from the blood samples of 150 patients with gastric cancer and 60 healthy participants.The mean particle size and concentration of serum exosome in the patients with gastric cancer were 104.6 nm (93.97-115.84) and 6.21e+009 particles/ml (5.15e+009-7.12e+009), respectively. miR-3184-5p expression was substantially downregulated in the patients with gastric cancer compared with that in the healthy participants.The gastric cancer cell line HGC-27 was cultured and transfected with the mimic and an inhibitor to overexpress and inhibit miR-3184-5p expression. miR-3184-5p strongly suppressed cell proliferation, migration, and invasion but induced cell apoptosis. Luciferase reporter assay revealed that XBP1 was the target of miR-3184-5p. miR-3184-5p substantially downregulated the expression of CD44, cyclin D1, MMP2, p65, p-AKT, and p-STAT3 but upregulated that of GRP78, IRE1, p-JNK, and CHOP. Moreover, miR-3184-5p cleaved caspase-12 and inhibited BCL-2 expression. These results suggested that the downregulation of miR-3184-5p in patients with gastric cancer might regulate the AKT, STAT3, and IRE1 pathways to promote the vitality of gastric cancer cells.

Background and Purpose Findings whether laparoscopic lymphadenectomy with spleen kept in situ or laparotomy with spleen lifted out of the abdomen is more effective remain inconclusive. This study is aimed at comparing outcomes of spleen-preserving splenic regional laparoscopic lymphadenectomy with spleen kept in situ versus laparotomy with spleen lifted out of the abdomen for locally advanced proximal gastric cancer. Methods Data from patients with locally advanced proximal gastric cancer were collected from January 2011 to January 2014. A total of 246 patients were identified who received D2 radical total gastrectomy together with spleen-preserving splenic regional lymphadenectomy. Of those patients, 87 patients underwent laparoscopic splenic regional lymphadenectomy with spleen kept in situ (LSKS-SRLA) and 159 patients underwent laparotomy with spleen lifted out of the abdomen (LSLA-SRLA). Surgical outcomes and long-term outcomes were compared between the two groups. Results The total number of lymph node dissection, intraoperative blood loss volume, intraoperative injury cases, and postoperative complications had no statistically significant difference between the two groups. The number of splenic regional lymph node dissections was 3.90 ± 1.05 per case in the LSLA-SRLA group and 2.89 ± 1.04 in the LSKS-SRLA group. The operation time, length of the incision, and hospital days were shorter in the LSKS-SRLA group. The total recurrence and metastatic rates and 3-year cumulative survival rate had no statistically significant difference between the two groups. Conclusions Similar long-term outcomes were achieved in the LSKS-SRLA and LSLA-SRLA groups for locally advanced proximal gastric cancer. However, in the aspects of surgical time, length of incision, and postoperative recovery, the LSKS-SRLA group had obvious advantages.