常规血液生物标志物在英国生物库队列中检测结直肠癌的附加诊断和诊断价值。

Additive pre-diagnostic and diagnostic value of routine blood-based biomarkers in the detection of colorectal cancer in the UK Biobank cohort.

机构信息

Engineering and Data Science Team, Sanome Limited, 15 Bishopsgate, London, EC2N 3AR, UK.

出版信息

Sci Rep. 2023 Jan 24;13(1):1367. doi: 10.1038/s41598-023-28631-y.

Abstract

Survival rates from colorectal cancer (CRC) are drastically higher if the disease is detected and treated earlier. Current screening guidelines involve stool-based tests and colonoscopies, whose acceptability and uptake remains low. Routinely collected blood-based biomarkers may offer a low-cost alternative or aid for detecting CRC. Here we aimed to evaluate the pre-diagnostic and diagnostic value of a wide-range of multimodal biomarkers in the UK Biobank dataset, including sociodemographic, lifestyle, medical, physical, and blood and urine-based measures in detecting CRC. We performed a Cox proportional hazard and a tree-boosting model alongside feature selection methods to determine optimal combination of biomarkers. In addition to the modifiable lifestyle factors of obesity, alcohol consumption and cardiovascular health, we showed that blood-based biomarkers that capture the immune response, lipid profile, liver and kidney function are associated with CRC risk. Following feature selection, the final Cox and tree-boosting models achieved a C-index of 0.67 and an AUC of 0.76 respectively. We show that blood-based biomarkers collected in routine examinations are sensitive to preclinical and clinical CRC. They may provide an additive value and improve diagnostic accuracy of current screening tools at no additional cost and help reduce burden on the healthcare system.

摘要

如果结肠癌(CRC)能够更早地被发现和治疗,其存活率会大幅提高。目前的筛查指南涉及粪便检测和结肠镜检查,但这些方法的接受度和采用率仍然较低。常规采集的基于血液的生物标志物可能是一种低成本的替代方法或辅助手段,用于检测 CRC。在这里,我们旨在评估英国生物库数据集内多种模态生物标志物的诊断前和诊断价值,包括社会人口统计学、生活方式、医疗、身体以及血液和尿液测量,以检测 CRC。我们使用 Cox 比例风险和树增强模型以及特征选择方法,以确定生物标志物的最佳组合。除了肥胖、饮酒和心血管健康等可改变的生活方式因素外,我们还表明,能够反映免疫反应、脂质谱、肝肾功能的基于血液的生物标志物与 CRC 风险相关。经过特征选择后,最终的 Cox 和树增强模型的 C 指数分别达到 0.67 和 0.76。我们表明,在常规检查中采集的基于血液的生物标志物对临床前和临床 CRC 很敏感。它们可能具有附加价值,并提高现有筛查工具的诊断准确性,而无需额外费用,并有助于减轻医疗保健系统的负担。

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