AUTHOR=Xie Li , Jiang Xiyi , Li Qian , Sun Zujun , Quan Wenqiang , Duan Yuping , Li Dong , Chen Tianhui 

TITLE=Diagnostic Value of Methylated Septin9 for Colorectal Cancer Detection

JOURNAL=Frontiers in Oncology

VOLUME=8

YEAR=2018

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2018.00247

DOI=10.3389/fonc.2018.00247

ISSN=2234-943X

ABSTRACT=<sec id="ST1"><title>Background</title><p>Methylated <italic>Septin9</italic> (<italic>mSEPT9</italic>) has been suggested as a reliable biomarker in colorectal cancer (CRC) detection. We aimed to determine the diagnostic value of <italic>mSEPT9</italic> for CRC detection in Chinese patients. In addition, we compared the diagnostic efficacy of <italic>mSEPT9</italic> to traditional screening method [fecal occult blood test (FOBT)] and two biomarkers [carcinoembryonic antigen (CEA) and carbohydrate antigen-199 (Ca-199)].</p></sec><sec id="ST2"><title>Methods</title><p>Overall 248 subjects including 123 patients with CRC and 125 controls were included. Plasma and fecal samples were collected for CEA, Ca-199, <italic>mSEPT9</italic>, and FOBT tests. Sensitivity and specificity were calculated to evaluate the diagnostic efficacy of each method; receiver operating characteristic (ROC) curve was plotted for the assessment of diagnostic accuracy, and comparisons among FOBT, <italic>mSEPT9</italic>, and the combination were assessed through area under the ROC curve (AUC).</p></sec><sec id="ST3"><title>Results</title><p><italic>mSEPT9</italic> achieved overall sensitivity and specificity of 61.8% [95% confidence interval (CI): 53.0–69.9%] and 89.6% (83.0–93.8%), respectively, with an AUC value of 0.757 (95% CI: 0.701–0.807), superior to FOBT [sensitivity: 61.4% (50.9–70.9%); specificity: 70.3% (59.1–79.5%); AUC: 0.658 (0.578–0.723)], CEA [sensitivity: 35.0% (27.1–43.7%); specificity: 62.6% (53.8–70.7%); AUC: 0.485 (0.411–0.559)], and Ca-199 [sensitivity: 17.9% (12.1–25.6%); specificity: 55.7% (48.9–64.1%); AUC: 0.353 (0.283–0.423)]. The combination of <italic>mSEPT9</italic> and FOBT further improved sensitivity and AUC value of 84.1% (75.1–90.3%) and 0.807 (0.752–0.863), respectively, while specificity was declined to 62.2% (50.8–72.4%).</p></sec><sec id="ST4"><title>Conclusion</title><p><italic>mSEPT9</italic> demonstrated best diagnostic ability in CRC detection compared with FOBT, CEA, and Ca-199. The combination of <italic>mSEPT9</italic> and FOBT further improved diagnostic sensitivity especially for early stage disease, which may provide a new approach for future CRC screening, though further investigations are warranted.</p></sec>