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Although miR-21 was secreted in CRC cell lines and upregulated in patients, no statistically significant differences were observed with the expression of miR-31 between individuals with CRC and control subjects. In the validation cohort, miR-21 levels were statistically significantly elevated compared to patients with adenomas P 0. 001 and CRC P 0. 001. Importantly, miR-21 expression was reduced in the post-operative serum of those undergoing curative surgery P 0. 001. Serum miR-21 concentrations strongly individualized adenomas area under the curve AUC 0. 813, 95 confidence interval CI 0. 691-0. 910 and CRC AUC 0. 919, 95 CI 0. 867 to 0. 958 compared to the control group. High expression of serum and tissue miR-21 was statistically and significantly related to tumor cheap di-hydan, online metastasis, and worse survival. Furthermore, serum miR-21 was an independent prognostic marker of CRC hazard ratio 4. 12, 95 CI 1.
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