Ferlizza Enea, Solmi Rossella, Sgarzi Michela, Ricciardiello Luigi, Lauriola Mattia
Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy.
Gastroenterology Unit, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy.
Cancers (Basel). 2021 Mar 4;13(5):1101. doi: 10.3390/cancers13051101.
Colorectal cancer (CRC) is the third most common form of cancer in terms of incidence and the second in terms of mortality worldwide. CRC develops over several years, thus highlighting the importance of early diagnosis. National screening programs based on fecal occult blood tests and subsequent colonoscopy have reduced the incidence and mortality, however improvements are needed since the participation rate remains low and the tests present a high number of false positive results. This review provides an overview of the CRC screening globally and the state of the art in approaches aimed at improving accuracy and participation in CRC screening, also considering the need for gender and age differentiation. New fecal tests and biomarkers such as DNA methylation, mutation or integrity, proteins and microRNAs are explored, including recent investigations into fecal microbiota. Liquid biopsy approaches, involving novel biomarkers and panels, such as circulating mRNA, micro- and long-non-coding RNA, DNA, proteins and extracellular vesicles are discussed. The approaches reported are based on quantitative PCR methods that could be easily applied to routine screening, or arrays and sequencing assays that should be better exploited to describe and identify candidate biomarkers in blood samples.
结直肠癌（CRC）在全球范围内的发病率位居第三，死亡率位居第二。CRC的发展历经数年，这凸显了早期诊断的重要性。基于粪便潜血试验及后续结肠镜检查的国家筛查项目已降低了发病率和死亡率，然而仍需改进，因为参与率依然较低，且这些检查存在大量假阳性结果。本综述概述了全球范围内的CRC筛查以及旨在提高CRC筛查准确性和参与度的先进方法，同时也考虑到性别和年龄差异的必要性。探讨了新的粪便检测和生物标志物，如DNA甲基化、突变或完整性、蛋白质和微小RNA，包括近期对粪便微生物群的研究。讨论了液体活检方法，涉及新型生物标志物和检测组合，如循环mRNA、微小和长链非编码RNA、DNA、蛋白质和细胞外囊泡。所报道的方法基于可轻松应用于常规筛查的定量PCR方法，或应更好地用于描述和识别血样中候选生物标志物的阵列和测序分析。
