Chen Hongda, Werner Simone, Butt Julia, Zörnig Inka, Knebel Phillip, Michel Angelika, Eichmüller Stefan B, Jäger Dirk, Waterboer Tim, Pawlita Michael, Brenner Hermann
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Division of Molecular Diagnostics of Oncogenic Infections, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Oncotarget. 2016 Mar 29;7(13):16420-32. doi: 10.18632/oncotarget.7500.
Novel blood-based screening tests are strongly desirable for early detection of colorectal cancer (CRC). We aimed to identify and evaluate autoantibodies against tumor-associated antigens as biomarkers for early detection of CRC. 380 clinically identified CRC patients and samples of participants with selected findings from a cohort of screening colonoscopy participants in 2005-2013 (N=6826) were included in this analysis. Sixty-four serum autoantibody markers were measured by multiplex bead-based serological assays. A two-step approach with selection of biomarkers in a training set, and validation of findings in a validation set, the latter exclusively including participants from the screening setting, was applied. Anti-MAGEA4 exhibited the highest sensitivity for detecting early stage CRC and advanced adenoma. Multi-marker combinations substantially increased sensitivity at the price of a moderate loss of specificity. Anti-TP53, anti-IMPDH2, anti-MDM2 and anti-MAGEA4 were consistently included in the best-performing 4-, 5-, and 6-marker combinations. This four-marker panel yielded a sensitivity of 26% (95% CI, 13-45%) for early stage CRC at a specificity of 90% (95% CI, 83-94%) in the validation set. Notably, it also detected 20% (95% CI, 13-29%) of advanced adenomas. Taken together, the identified biomarkers could contribute to the development of a useful multi-marker blood-based test for CRC early detection.
新型血液筛查测试对于早期发现结直肠癌(CRC)非常必要。我们旨在鉴定和评估针对肿瘤相关抗原的自身抗体,作为早期检测CRC的生物标志物。本分析纳入了380例经临床确诊的CRC患者以及2005 - 2013年一组筛查结肠镜检查参与者中具有特定检查结果的参与者样本(N = 6826)。通过基于多重微珠的血清学检测方法测量了64种血清自身抗体标志物。采用了两步法,即在训练集中选择生物标志物,并在验证集中验证结果,验证集仅包括筛查人群中的参与者。抗MAGEA4在检测早期CRC和进展性腺瘤方面表现出最高的敏感性。多标志物组合以适度降低特异性为代价,显著提高了敏感性。抗TP53、抗IMPDH2、抗MDM2和抗MAGEA4始终包含在性能最佳的4、5和6标志物组合中。在验证集中,这个四标志物组合对早期CRC的敏感性为26%(95%CI,13 - 45%),特异性为90%(95%CI,83 - 94%)。值得注意的是,它还检测出了20%(95%CI,13 - 29%)的进展性腺瘤。综上所述,所鉴定的生物标志物有助于开发一种有用的基于血液的多标志物CRC早期检测测试。