Diagnostic Utility of microRNA146a and microRNA19a in Gallbladder Cancer: A Pilot Study.

Gallbladder cancer (GBC) is a rare but aggressive malignancy, often diagnosed at advanced stages due to its asymptomatic progression and lack of reliable biomarkers. Chronic inflammation plays a crucial role in its pathogenesis, with inflammatory pathways contributing to tumor development. This study evaluates the diagnostic potential of microRNA19a and microRNA146a, key regulators of inflammatory and oncogenic pathways, in distinguishing GBC from cholelithiasis and healthy controls. An observational analytical study was conducted on 60 participants, divided into three groups: GBC (n = 20), cholelithiasis (n = 20), and non-dysplastic/healthy controls (n = 20). microRNA expression levels in tissue and plasma samples were quantified using RT-PCR and qPCR, with ΔCq values normalized to U6 RNA. Receiver Operating Characteristic (ROC) analysis assessed diagnostic performance, and correlations between tissue and plasma expression levels were examined. Most GBC cases (65%) were diagnosed at Stage IV, with 75% showing liver infiltration. microRNA19a and microRNA146a expression levels were significantly elevated in GBC tissues compared to the other groups (p < 0.0001). Plasma microRNA146a demonstrated high diagnostic accuracy, with an AUC of 0.953, sensitivity of 80%, and specificity of 95%, outperforming microRNA19a (AUC 0.388, sensitivity 20%, specificity 95%). Strong positive correlations between tissue and plasma expression were observed for microRNA146a (r = 0.693, p = 0.0007) and microRNA19a (r = 0.564, p = 0.010), supporting their potential as circulating biomarkers. microRNA146a exhibits good diagnostic utility in differentiating GBC, particularly in advanced disease stages, while microRNA19a reflects inflammation-driven carcinogenesis. Plasma-based microRNA detection offers a promising noninvasive diagnostic approach for early and accurate GBC detection. Further large-scale studies are warranted to validate these biomarkers and explore their therapeutic implications.