Evaluation of a 5-Marker Blood Test for Colorectal Cancer Early Detection in a Colorectal Cancer Screening Setting
| Autor: | Hermann Brenner, Simone Werner, Matthias Strobl, Vinzent Rolny, David Morgenstern, Hongda Chen, Friedemann Krause, Christian Datz |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Oncology Cancer Research medicine.medical_specialty Colorectal cancer Sensitivity and Specificity 03 medical and health sciences 0302 clinical medicine Carcinoembryonic antigen Internal medicine Biomarkers Tumor medicine Humans Mass Screening Blood test Early Detection of Cancer Mass screening Aged Neoplasm Staging Hematologic Tests medicine.diagnostic_test biology business.industry Stool test Carcinoma in situ Fecal occult blood Reproducibility of Results Cancer Middle Aged medicine.disease ROC Curve Case-Control Studies 030220 oncology & carcinogenesis biology.protein Female 030211 gastroenterology & hepatology Colorectal Neoplasms business |
| Zdroj: | Clinical Cancer Research. 22:1725-1733 |
| ISSN: | 1557-3265 1078-0432 |
| DOI: | 10.1158/1078-0432.ccr-15-1268 |
| Popis: | Purpose: In initial studies that included colorectal cancer patients undergoing diagnostic colonoscopy, we had identified a serum marker combination able to detect colorectal cancer with similar diagnostic performance as fecal immunochemical test (FIT). In this study, we aimed to validate the results in participants of a large colorectal cancer screening study conducted in the average-risk, asymptomatic screening population. Experimental Design: We tested serum samples from 1,200 controls, 420 advanced adenoma patients, 4 carcinoma in situ patients, and 36 colorectal cancer patients with a 5-marker blood test [carcinoembryonic antigen (CEA)+anti-p53+osteopontin+seprase+ferritin]. The diagnostic performance of individual markers and marker combinations was assessed and compared with stool test results. Results: AUCs for the detection of colorectal cancer and advanced adenomas with the 5-marker blood test were 0.78 [95% confidence interval (CI), 0.68–0.87] and 0.56 (95% CI, 0.53–0.59), respectively, which now is comparable with guaiac-based fecal occult blood test (gFOBT) but inferior to FIT. With cutoffs yielding specificities of 80%, 90%, and 95%, the sensitivities for the detection of colorectal cancer were 64%, 50%, and 42%, and early-stage cancers were detected as well as late-stage cancers. For osteopontin, seprase, and ferritin, the diagnostic performance in the screening setting was reduced compared with previous studies in diagnostic settings while CEA and anti-p53 showed similar diagnostic performance in both settings. Conclusions: Performance of the 5-marker blood test under screening conditions is inferior to FIT even though it is still comparable with the performance of gFOBT. CEA and anti-p53 could contribute to the development of a multiple marker blood-based test for early detection of colorectal cancer. Clin Cancer Res; 22(7); 1725–33. ©2015 AACR. |
| Databáze: | OpenAIRE |
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