期刊
EBIOMEDICINE
卷 25, 期 -, 页码 32-40出版社
ELSEVIER
DOI: 10.1016/j.ebiom.2017.10.005
关键词
Colorectal cancer; Early diagnosis; Clostridium symbiosum; Quantitative PCR
资金
- National Natural Science Foundation of China [81421001, 81320108024, 81530072, 81572303, 81001070]
- National Key Technology RD Program [2014BAI09B05, 2016YFC0906002]
- Top-Notch project of China and Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant [20152514]
Objective: Current non-invasive early detection of colorectal cancer (CRC) requires improvement. We aimed to identified a fecal Clostridium symbiosum-based biomarker for early and advanced colorectal cancer detection. Design: In the test stage, the relative abundance of Clostridium symbiosum(C. symbiosum) was measured by qPCR in 781 cases including 242 controls, 212 colorectal adenoma (CRA) patients, 109 early CRC (tumor restricted to the submucosa) patients, 218 advanced CRC patients. The prediction accuracy was compared to Fusobacterium nucleatum (F. nucleatum), fecal immunochemical test (FIT) and CEA (carcinoembryonic antigen) and validated in an independent cohort of 256 subjects. Current status of the trial: ongoing/still enrolling. Primary endpoint:June, 2017 (Clinicaltrials.gov Identifier NCT02845973). Results: Significant stepwise increase of C. symbiosum abundance was found in CRA, early CRC and advanced CRC (P < 0.01). C. symbiosum outperformed all the other markers in early CRC prediction performance. The combination of C. symbiosum and FIT achieved better performance (0.803 for test cohort and 0.707 for validation cohort). For overall discrimination of CRCs, the combination of all above markers achieved the performance of 0.876. Conclusions: Fecal C. symbiosum is a promising biomarker for early and noninvasive detection of colorectal cancer, being more effective than F. nucleatum, FIT and CEA. Combining C. symbiosum and FIT or CEA may improve the diagnosis power. (C) 2017 Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license
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