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    <journal-meta>
      <journal-id journal-id-type="nlm-ta">Avicenna J Med Biotech</journal-id>
      <journal-id journal-id-type="publisher-id">arij002</journal-id>
      <journal-title-group>
        <journal-title>Avicenna Journal of Medical Biotechnology</journal-title>
      </journal-title-group>
      <issn pub-type="ppub">2008-2835</issn>
      <issn pub-type="epub">2008-4625</issn>
      <publisher>
        <publisher-name>Avicenna Research Institute</publisher-name>
      </publisher>
    </journal-meta>

    <article-meta>
      <article-id pub-id-type="publisher-id">ajmb10370</article-id>
      <article-id pub-id-type="doi"></article-id>
      <article-id pub-id-type="pmid"></article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
             <subject></subject> 
        </subj-group>
        <subj-group>
            <subject></subject>
        </subj-group> 
      </article-categories>
      <title-group>
        <article-title>Methylation Analysis of P16, RASSF1A, RPRM, and RUNX3 in Circulating Cell-Free DNA for Detection of Gastric Cancer: A Validation Study</article-title>
      </title-group>
        <contrib-group><contrib contrib-type="author"><name><surname>Saliminejad</surname><given-names>Kioomars</given-names></name></contrib><aff>Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran</aff></contrib-group><contrib-group><contrib contrib-type="author"><name><surname>Soleymani Fard</surname><given-names>Shahrzad</given-names></name></contrib><aff>Department of Pharmacognosy, Sri K.V.College of Pharmacy, Chickballapur      , Karnataka, India</aff></contrib-group><contrib-group><contrib contrib-type="author"><name><surname>Khorram Khorshid</surname><given-names>Hamid Reza</given-names></name></contrib><aff>Molecular Immunology and Vaccine Research Laboratory, Pasteur Institute of Iran      , Tehran, Iran</aff></contrib-group><contrib-group><contrib contrib-type="author"><name><surname>Yaghmaei</surname><given-names>Marjan</given-names></name></contrib><aff>Department of Pharmaceutical Biotechnology and Biotechnology Research Center, Faculty of Pharmacy, Tehran      University of Medical Sciences, Tehran, Iran</aff></contrib-group><contrib-group><contrib contrib-type="author"><name><surname>Mahmoodzadeh</surname><given-names>Habibollah</given-names></name></contrib></contrib-group><contrib-group><contrib contrib-type="author"><name><surname>Mousavi</surname><given-names>Seyed Asadollah</given-names></name></contrib></contrib-group><contrib-group><contrib contrib-type="author"><name><surname>Ghaffari</surname><given-names>Seyed Hamidollah</given-names></name></contrib></contrib-group>
      <pub-date pub-type="ppub">
        <day></day>
        <month></month>
        <year></year>
      </pub-date>
      <pub-date pub-type="epub">
        <day></day>
        <month></month>
        <year></year>
      </pub-date>
      <volume>12</volume>
      <issue>2</issue>
      <fpage>99</fpage>
      <lpage>106</lpage>
      <history>
        <date date-type="received">
          <day>26</day>
          <month>6</month>
          <year>2019</year>
        </date>
        <date date-type="accepted">
          <day>7</day>
          <month>8</month>
          <year>2019</year>
        </date>
      </history>
      <abstract>
      <p>
      &lt;p&gt;Background: Most of Gastric Cancer (GC) patients are diagnosed at an advanced stage with poor prognosis. Hypermethylations of several tumor suppressor genes in cell-free DNA of GC patients have been previously reported. In this study, an attempt was made to investigate the methylation status of &lt;em&gt;P16&lt;/em&gt;, &lt;em&gt;RASSF1A&lt;/em&gt;, &lt;em&gt;RPRM&lt;/em&gt;, and &lt;em&gt;RUNX3 &lt;/em&gt;and their potentials for early diagnosis of GC.&lt;/p&gt;

&lt;p&gt;Methods: Methylation status of the four tumor suppressor genes in 96 plasma samples from histopathologically confirmed gastric adenocarcinoma patients (Stage I-IV) and 88 healthy controls was determined using methylation-specific PCR method. Receiver operating characteristic curve analysis was performed and Area Under the Curve (AUC) was calculated. Two tailed p&amp;lt;0.05 were considered statistically significant.&lt;/p&gt;

&lt;p&gt;Results: Methylated &lt;em&gt;P16&lt;/em&gt;, &lt;em&gt;RASSF1A&lt;/em&gt;, &lt;em&gt;RPRM&lt;/em&gt;, and &lt;em&gt;RUNX3&lt;/em&gt; were significantly higher in the GC patients (41.7, 33.3, 66.7, and 58.3%) compared to the controls (15.9, 0.0, 6.8, and 4.5%), respectively (p&amp;lt;0.001). Stratification of patients showed that &lt;em&gt;RPRM&lt;/em&gt; (AUC: 0.70, Sensitivity: 0.47, Specificity: 0.93, and p&amp;lt;0.001) and &lt;em&gt;RUNX3 &lt;/em&gt;(AUC: 0.77, Sensitivity: 0.59, Specificity: 0.95, and p&amp;lt;0.001) had the highest performances in detection of early-stage (I+II) GC. The combined methylation of &lt;em&gt;RPRM &lt;/em&gt;and &lt;em&gt;RUNX3 &lt;/em&gt;in detection of early-stage GC had a higher AUC of 0.88 (SE=0.042; 95% CI:0.793&amp;ndash;0.957; p&amp;lt;0.001), higher sensitivity of 0.82 and reduced specificity of 0.89.&lt;/p&gt;

&lt;p&gt;Conclusion: Methylation analysis of &lt;em&gt;RPRM &lt;/em&gt;and &lt;em&gt;RUNX3 &lt;/em&gt;in circulating cell free-DNA of plasma could be suggested as a potential biomarker for detection of GC in early-stages.&lt;/p&gt;

      </p>
      </abstract>
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