A fecal-based test for the detection of advanced adenoma and colorectal cancer: a case-control and screening cohort study
| Autor: | Pei-Rong Ding, Ting Zhou, Lian-Jing Cao, Tong-Min Wang, Xia-Ting Tong, Jiang-Bo Zhang, Li-Qing Zhu, Fang Wang, Wen-Qiong Xue, Kexin Chen, Rong Zhang, Ying Liao, Da-Wei Yang, Shi-Hong Zhang, Gai-Rui Li, Yong-Qiao He, Wei Hua Jia, Zi-Yi Wu, Xiao-Lin Peng |
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| Rok vydání: | 2021 |
| Předmět: |
Adenoma
medicine.medical_specialty Colorectal cancer Colonoscopy Logistic regression Gastroenterology Cohort Studies Internal medicine medicine Advanced adenoma Humans Early Detection of Cancer medicine.diagnostic_test business.industry Incidence (epidemiology) Area under the curve Noninvasive test General Medicine medicine.disease digestive system diseases Case-Control Studies Cohort Screening Medicine Fecal biomarkers Colorectal Neoplasms business Research Article Cohort study |
| Zdroj: | BMC Medicine BMC Medicine, Vol 19, Iss 1, Pp 1-15 (2021) |
| ISSN: | 1741-7015 |
| Popis: | Background Colorectal 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). Methods Through 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. Results The 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. Conclusions The 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. |
| Databáze: | OpenAIRE |
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