Intestinal Research

Original Article

Alteration of miR-21 and miR-24 expression: biomarker for early detection of synchronous metastases in colorectal cancer: a cross-sectional study in Indonesia: Yudith Annisa Ayu Rezkitha, Amal Arifi Hidayat, Irine Normalina, Ricky Indra Alfaray, Maria Inge Lusida, Takashi Matsumoto, Yoshio Yamaoka, Muhammad Miftahussurur; Received December 2, 2024 Accepted August 26, 2025 Published online November 19, 2025; DOI: https://doi.org/10.5217/ir.2024.00206 [Epub ahead of print]

Abstract PDF Supplementary Material PubReader ePub: Background/Aims
Timely detection with highly accurate biomarkers would be helpful in effectively managing colorectal cancer (CRC). We aim to investigate the accuracy of 3 emerging biomarkers—miR-21, miR-24, and miR-145—in detecting synchronous metastases in CRC.
Methods
We recruited newly diagnosed CRC patients with extensive investigations to determine cancer staging and metastatic status. The expression levels of miR-21, miR-24, and miR-145 in tumor biopsy were measured using reverse transcription quantitative polymerase chain reaction. Multivariate and receiver operating characteristic analyses were conducted to evaluate the association and performance of these miRNAs in identifying various metastases.
Results
Out of the 63 Indonesian patients involved, 37 (58.7%) were diagnosed with localized CRC, whereas the remaining 26 (41.3%) were identified as having metastases: 31.7% liver, 14.3% lung, 3.2% bone, and 4.8% other metastases. There was a significant downregulation of miR-24 expression in metastatic CRC patients compared to those without metastases (0.024 [4.680] vs. 12.900 [42.376], P< 0.01). Overexpression of miR-21 was identified as an independent risk factor of synchronous metastasis (odds ratio [OR], 1.016; 95% confidence interval [CI], 1.003–1.030; P< 0.05), particularly lung (OR, 1.011; 95% CI, 1.002–1.020; P< 0.05) and bone (OR, 1.022; 95% CI, 1.001–1.043; P< 0.05) metastases. No association was found between miR-145 expression and metastatic status. The miR-21/24 ratio accurately identified synchronous metastases irrespective of organ site, with an area under the curve (95% CI) of 0.833 (0.722–0.944) and positive predictive value of 94.4%.
Conclusions
Alteration of miR-21 and miR-24 expression levels was associated with a high incidence of synchronous metastases in Indonesian CRC. The mir-21/24 ratio demonstrated significant potential as a biomarker for detecting synchronous metastases in CRC.

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Review

Functional disorder

Diagnostic strategy of irritable bowel syndrome: a low- and middle-income country perspective: Amal Arifi Hidayat, Langgeng Agung Waskito, Titong Sugihartono, Hafeza Aftab, Yudith Annisa Ayu Rezkitha, Ratha-korn Vilaichone, Muhammad Miftahussurur; Intest Res 2024;22(3):286-296. Published online March 26, 2024; DOI: https://doi.org/10.5217/ir.2023.00199

Abstract PDF PubReader ePub

Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder associated with substantial impairment which considerably burdens healthcare systems worldwide. Research on IBS has largely been conducted in high-income countries posing barriers to the application of diagnostic strategies in low- and middle-income countries (LMICs) due to differences in disease characteristics, healthcare resources, and socioeconomic factors. This review discusses the diagnostic issues associated with LMICs. We present a concise overview of the relevant approaches and propose a diagnostic strategy based on the latest evidence. A positive diagnostic strategy that relies on appropriate symptom-based criteria is crucial within the diagnostic framework. A combination of complete blood count, fecal occult blood test, and complete stool test may reliably identify individuals with suspected IBS who are more likely to have organic diseases, thus justifying the necessity for a colonoscopy. Eventually, we developed a diagnostic algorithm based on a limited setting perspective that summarizes the available evidence and may be applied in LMICs.

Citations

Citations to this article as recorded by

2025 Seoul Consensus on Clinical Practice Guidelines for Irritable Bowel Syndrome
Yonghoon Choi, Young Hoon Youn, Seung Joo Kang, Jeong Eun Shin, Young Sin Cho, Yoon Suk Jung, Seung Yong Shin, Cheal Wung Huh, Yoo Jin Lee, Hoon Sup Koo, Kwangwoo Nam, Hong Sub Lee, Dong Hyun Kim, Ye Hyun Park, Min Cheol Kim, Hyo Yeop Song, Sung-Hoon Yoon
Journal of Neurogastroenterology and Motility.2025; 31(2): 133. CrossRef

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