Authors' Affiliations: Division of Developmental Therapeutics, Research Center for Innovative Oncology; Colorectal and Pelvic Surgery Division, National Cancer Center Hospital East, Kashiwa; Colorectal Surgery Division, National Cancer Center Hospital; and Screening Technology and Development Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
Cancer Epidemiol Biomarkers Prev. 2013 Oct;22(10):1844-52. doi: 10.1158/1055-9965.EPI-13-0512. Epub 2013 Aug 15.
Immunochemical fecal occult blood test (iFOBT) is widely used for colorectal cancer screening; however, its sensitivity is insufficient. We recently reported a fecal microRNA (miRNA) test (FmiRT) to detect colorectal cancer. In this study, we investigated a new colorectal cancer screening method combining iFOBT and FmiRT to improve the sensitivity compared with iFOBT alone.
In total, 117 colorectal cancer patients and 107 healthy volunteers were enrolled. Ten-milligram fecal samples were collected and iFOBT was conducted. Fecal RNA was extracted from residuum of iFOBT and then the expression of 14 kinds of miRNA was analyzed for the FmiRT using real-time reverse transcription PCR.
Levels of fecal miR-106a expression in iFOBT+ patients and iFOBT- patients were significantly higher than in healthy volunteers (P = 0.001). The sensitivity and specificity of FmiRT using miR-106a were 34.2% and 97.2%, and those of iFOBT were 60.7% and 98.1%, respectively. The overall sensitivity and specificity of the new screening method combining iFOBT and FmiRT were 70.9% and 96.3%, respectively. One quarter of colorectal cancer patients with false-negative iFOBT seemed to be true positive upon adding FmiRT using fecal miR-106a.
Fecal miR-106a is a good molecular marker to identify colorectal cancer patients from among those with negative iFOBT results. FmiRT combined with iFOBT may improve the sensitivity to detect colorectal cancer.
We have shown the usefulness of fecal miR-106a to detect the colorectal cancer patients among those with negative iFOBT results.
免疫化学粪便潜血试验（iFOBT）被广泛用于结直肠癌筛查；然而，其灵敏度不足。我们最近报道了一种粪便 microRNA（miRNA）检测（FmiRT）来检测结直肠癌。在这项研究中，我们研究了一种新的结直肠癌筛查方法，将 iFOBT 与 FmiRT 相结合，以提高与单独使用 iFOBT 相比的灵敏度。
共纳入 117 例结直肠癌患者和 107 例健康志愿者。采集 10mg 粪便样本进行 iFOBT。从 iFOBT 的残渣中提取粪便 RNA，然后使用实时逆转录 PCR 分析 FmiRT 中 14 种 miRNA 的表达。
iFOBT+患者和 iFOBT-患者粪便 miR-106a 表达水平明显高于健康志愿者（P=0.001）。FmiRT 检测 miR-106a 的灵敏度和特异性分别为 34.2%和 97.2%，iFOBT 分别为 60.7%和 98.1%。iFOBT 和 FmiRT 联合新筛查方法的总灵敏度和特异性分别为 70.9%和 96.3%。四分之一的 iFOBT 假阴性结直肠癌患者似乎在添加粪便 miR-106a 的 FmiRT 后呈真阳性。
粪便 miR-106a 是识别 iFOBT 阴性结果的结直肠癌患者的良好分子标志物。FmiRT 联合 iFOBT 可能提高检测结直肠癌的灵敏度。
我们已经证明了粪便 miR-106a 在检测 iFOBT 阴性结果的结直肠癌患者中的有用性。
