• Lian-Jing Cao, Xiao-Lin Peng, Wen-Qiong Xue, Rong Zhang, Jiang-Bo Zhang, Ting Zhou, Zi-Yi Wu, Gai-Rui Li, Tong-Min Wang, Yong-Qiao He, Da-Wei Yang, Ying Liao, Xia-Ting Tong, Fang Wang, Ke-Xin Chen, Shi-Hong Zhang, Li-Qing Zhu, Pei-Rong Ding, and Wei-Hua Jia.
• State Key Laboratory of Oncology in South China Guangzhou, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
• Bmc Med. 2021 Oct 25; 19 (1): 250.

BackgroundColorectal cancer (CRC) is the leading cause of cancer death worldwide. Screening is a confirmed way to reduce the incidence and mortality rates of CRC. This study aimed to identify a fecal-based, noninvasive, and accurate method for detection of colorectal cancer (CRC) and advanced adenoma (AA).MethodsThrough detection in tissue (n = 96) and fecal samples (n = 88) and tested in an independent group of fecal samples (n = 294), the methylated DNA marker ITGA4 and bacterial markers Fusobacterium nucleatum (Fn) and Pepetostreptococcusanaerobius (Pa) were identified from the candidate biomarkers for CRC and AA detection. A prediction score (pd-score) was constructed using the selected markers and fecal immunochemical test (FIT) for distinguishing AA and CRC from healthy subjects by logistic regression method. The diagnostic performance of the pd-score was compared with FIT and validated in the external validation cohort (n = 117) and in a large CRC screening cohort.ResultsThe pd-score accurately identified AA and CRC from healthy subjects with an area under the curve (AUC) of 0.958, at a specificity of 91.37%; the pd-score showed sensitivities of 95.38% for CRC and 70.83% for AA, respectively. In the external validation cohort, the sensitivities of the pd-score for CRC and AA detection were 94.03% and 80.00%, respectively. When applied in screening, the pd-score identified 100% (11/11) of CRC and 70.83% (17/24) of AA in participants with both colonoscopy results and qualified fecal samples, showing an improvement by 41.19% compared to FIT.ConclusionsThe current study developed a noninvasive and well-validated approach for AA and CRC detection, which could be applied widely as a diagnostic and screening test.© 2021. The Author(s).

12 keywords...

hide…