Role of long noncoding RNAs in differentiating colorectal polyps from cancer: expression profiles and exploratory pathway enrichment of reported lncRNA targets.

Colorectal cancer is one of the most common malignancies worldwide and often develops from precancerous polyps. Early detection and differentiation of polyp types are essential for prevention and management. This study evaluated long non-coding RNA (lncRNA) expression levels in hyperplastic polyps(HP), adenomatous polyps(A), and colon adenocarcinomas(CA) tissues to assess their diagnostic potential as tissue-based candidate biomarkers for distinguishing CA from A and HP tissues. Formalin-fixed paraffin-embedded colon tissue samples from 120 patients were analyzed, including 40 CA, 40 A, and 40 HP. Expression levels of CCAT1, CCAT2, HOTAIR, HOTTIP, GAS5, LNCP21, H19, and MALAT1 were quantified by qRT-PCR. Statistical analyses were performed using PRISM9.2.0. Diagnostic performance was evaluated by ROC analysis, including AUC, sensitivity, and specificity. Age- and sex-adjusted logistic regression models were performed. Several lncRNAs were differentially expressed among CA, A, and HP groups. ROC analyses showed strong diagnostic performance for HOTAIR, CCAT2, and MALAT1, with AUC values of 0.896, 0.834, and 0.833, respectively. LNCP21, HOTTIP, H19, and CCAT1 also demonstrated significant discriminatory ability after multiple-testing correction. In age- and sex-adjusted logistic regression analyses, HOTAIR, LNCP21, H19, CCAT2, CCAT1, MALAT1, and HOTTIP remained independently associated with colorectal adenocarcinoma, whereas GAS5 showed limited discriminatory value. Exploratory pathway enrichment analysis suggested involvement of WNT/β-catenin/MYC, p53/ubiquitin-mediated, and inflammatory JAK-STAT/EGFR-related signaling pathways. HOTAIR, CCAT2, MALAT1, LNCP21, HOTTIP, H19, and CCAT1 showed potential diagnostic value for distinguishing CA from A and HP, with HOTAIR, CCAT2, and MALAT1 exhibiting the strongest performance. Pathway enrichment findings provide exploratory biological context and require validation in larger prospective studies and functional analyses.