Caraballo Elba V, Centeno-Girona Hilmaris, Torres-Velásquez Brenda Carolina, Martir-Ocasio Madeline M, González-Pons María, López-Acevedo Sheila N, Cruz-Correa Marcia
Division of Clinical and Translational Cancer Research, University of Puerto Rico Comprehensive Cancer Center, San Juan 00921, Puerto Rico.
School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan 00921, Puerto Rico.
Cancers (Basel). 2024 Dec 15;16(24):4176. doi: 10.3390/cancers16244176.
Colorectal cancer (CRC) is a leading cause of death worldwide. Despite its preventability through screening, compliance still needs to improve due to the invasiveness of current tools. There is a growing demand for validated molecular biomarker panels for minimally invasive blood-based CRC screening. This study assessed the diagnostic accuracy of four promising blood-based CRC biomarkers, individually and in combination. This case-control study involved plasma samples from 124 CRC cases and 124 age- and sex-matched controls. Biomarkers tested included methylated DNA encoding the Septin-9 gene () using Epi proColon 2.0 CE, insulin-like growth factor binding protein 2 (IGFBP2), dickkopf-3 (DKK3), and pyruvate kinase M2 (PKM2) by ELISA. Diagnostic accuracy was measured using the receiver operating characteristic (ROC), area under the curve (AUC), as well as sensitivity and specificity. Diagnostic accuracy for , IGFBP2, DKK3, and PKM2 was 62.9% (95% CI: 56.8-62.9%), 69.7% (95% CI: 63.1-69.7%), 61.6% (95% CI: 54.6-61.6%), and 50.8% (95% CI: 43.4-50.8%), respectively. The combined biomarkers yielded an AUC of 74.4% (95% CI: 68.1-80.6%), outperforming all biomarkers except IGFBP2. These biomarkers show potential for developing a minimally invasive CRC detection tool as an alternative to existing approaches, potentially increasing adherence, early detection, and survivorship.
结直肠癌(CRC)是全球主要的死亡原因之一。尽管通过筛查可预防CRC,但由于现有检测工具具有侵入性,筛查的依从性仍有待提高。对于经过验证的用于基于血液的微创CRC筛查的分子生物标志物组合的需求日益增长。本研究评估了四种有前景的基于血液的CRC生物标志物单独及联合使用时的诊断准确性。这项病例对照研究纳入了124例CRC患者和124例年龄及性别匹配的对照的血浆样本。检测的生物标志物包括使用Epi proColon 2.0 CE检测甲基化的编码Septin-9基因的DNA(),通过酶联免疫吸附测定法检测胰岛素样生长因子结合蛋白2(IGFBP2)、Dickkopf-3(DKK3)和丙酮酸激酶M2(PKM2)。使用受试者工作特征(ROC)曲线、曲线下面积(AUC)以及灵敏度和特异度来衡量诊断准确性。、IGFBP2、DKK3和PKM2的诊断准确性分别为62.9%(95%置信区间:56.8 - 62.9%)、69.7%(95%置信区间:63.1 - 69.7%)、61.6%(95%置信区间:54.6 - 61.6%)和50.8%(95%置信区间:43.4 - 50.8%)。联合生物标志物的AUC为74.4%(95%置信区间:68.1 - 80.6%),除IGFBP2外,优于所有生物标志物。这些生物标志物显示出开发一种微创CRC检测工具以替代现有方法的潜力,可能会提高依从性、实现早期检测并提高生存率。