Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands.
Clin Colorectal Cancer. 2011 Mar 1;10(1):8-23. doi: 10.3816/CCC.2011.n.002.
Detecting and removing high-risk adenomas and early colorectal cancer (CRC) can reduce mortality of this disease. The noninvasive fecal occult blood test (FOBT; guaiac-based or immunochemical) is widely used in screening programs and although effective, it leaves room for improvement in terms of test accuracy. Molecular tests are expected to be more sensitive, specific and informative than current detection tests, and are promising future tools for CRC screening. This review provides an overview of the performances of DNA, RNA, and protein markers for CRC detection in stool and blood. Most emphasis currently is on DNA and protein markers. Among DNA markers there is trend to move away from mutation markers in favor of methylation markers. The recent boost in proteomics research leads to many new candidate protein markers. Usually in small series, some markers show better performance than the present FOBT. Evaluation in large well-controlled randomized trials is the next step needed to take molecular markers for CRC screening to the next level and warrant implementation in a screening setting.
检测和切除高危腺瘤和早期结直肠癌（CRC）可以降低这种疾病的死亡率。非侵入性粪便潜血试验（FOBT；愈创木脂或免疫化学）广泛用于筛查计划中，虽然有效，但在检测准确性方面仍有改进的空间。与目前的检测试验相比，分子试验预计更敏感、更特异和更具信息量，是 CRC 筛查有前途的未来工具。这篇综述概述了粪便和血液中用于 CRC 检测的 DNA、RNA 和蛋白质标记物的性能。目前大多数重点是 DNA 和蛋白质标记物。在 DNA 标记物中，有一种趋势是远离突变标记物，转而支持甲基化标记物。蛋白质组学研究的最新进展带来了许多新的候选蛋白质标记物。通常在小系列中，一些标记物的表现优于目前的 FOBT。在大型、良好对照的随机试验中进行评估是将 CRC 筛查的分子标记物提升到一个新水平并保证在筛查环境中实施所需要的下一步。
