A Prospective Study of Comparing Multi-Gene Biomarker Chip and Serum Carcinoembryonic Antigen in the Postoperative Surveillance for Patients with Stage I-III Colorectal Cancer

Abstract

BackgroundCirculating biomarkers can predict clinical outcomes in colorectal cancer patients. The aim of the study was to evaluate the feasibility of our multigene biomarker chip for detecting circulating tumor cells for postoperative surveillance of stage I–III colorectal cancer patients.Materials and MethodsIn total, 298 stage I–III colorectal cancer patients were analyzed after curative resection between June 2010 and October 2014. During each follow-up, a postoperative surveillance strategy, including ESMO Guidelines Working Group recommendations and the biochip, was used.ResultsAfter a 28.4-month median follow-up, 48 (16.1%) patients had postoperative relapse. Univariate analysis revealed that the postoperative relapse risk factors were rectal tumor, perineural invasion, elevated preoperative and postoperative serum carcinoembryonic antigen levels, and positive biochip results (all P < 0.05). Multivariate analyses revealed that postoperative relapse correlated significantly with elevated postoperative serum carcinoembryonic antigen levels (odds ratio = 4.136, P = 0.008) and positive biochip results (odds ratio = 66.878, P < 0.001). However, the sensitivity (P = 0.003), specificity (P = 0.003), positive (P = 0.002) and negative (P = 0.006) predictive values, and accuracy (P < 0.001) of the biochip for predicting postoperative relapse were significantly higher than those of elevated postoperative serum carcinoembryonic antigen levels. Moreover, the median lead time between positive biochip result and postoperative relapse detection was significantly earlier than that between elevated postoperative serum carcinoembryonic antigen level and postoperative relapse detection (10.7 vs. 2.8 months, P < 0.001). Furthermore, positive biochip results correlated strongly with lower disease-free survival and overall survival of colorectal cancer patients (both P < 0.001).ConclusionCompared with conventional serum carcinoembryonic antigen detection, our multigene chip aided more accurate and earlier prediction of postoperative relapse during stage I–III colorectal cancer patient surveillance. In clinical practice, this biochip may facilitate early postoperative relapse diagnosis in colorectal cancer patients.

Dose-Dependent Relationship Between Metformin and Colorectal Cancer Occurrence Among Patients with Type 2 Diabetes—A Nationwide Cohort Study

“…According to the Ministry of Health and Welfare of Taiwan, since 2006, CRC has become the most common cancer and the third most common cause of cancer-related death. In 2015, the incidence of CRC was 44.3 per 100,000 population, with 24.2 deaths per 100,000 population and an average of 12.9 years of life lost in Taiwan ( http://mohw.gov.tw/CHT/DOS/Index.aspx ; accessed in December 2016) [1] . Various molecular markers and many clinical epidemiological factors, such as being overweight or obese, physical inactivity, certain types of diets, smoking, heavy alcohol use, a personal history of inflammatory bowel disease, colorectal polyps or CRC, and family history of adenomatous polyps or CRC, have been identified.…”

<p>Common molecular markers between circulating tumor cells and blood exosomes in colorectal cancer: a systematic and analytical review</p>

“…26,383,518CanPatrol CTC enrichment(ISH) assay–5 mL38 patients, 27 controls/BloodI–IVWu, 2015 11067%25,909,322PSG2, ELAVL4, TK1, UBE2C, PDE6D, PSAT1, CHRNB1, BMI1, CAP2, MMP13, OLFM4, PTTG1, MYC, MET, MUC1, HMGB1, hTERT, BIRC5,Enzyme immunoassay test kit–CEA3 mL298 patients/BloodI–IIIChang, 2016 138-27,701,415PI3Kα, Akt-2, Twist1 ALDH1antiCD45 specific antibodies (Dynabeads, Invitrogen)qRT-PCR and multiplex-PCR_8 mL78 patients, 20 controls/BloodI–IVNing, 2018 129…”

Current Applications and Future Directions of Circulating Tumor Cells in Colorectal Cancer Recurrence

“…The authors also found that the interval at which positive CTCs were detected was 6 months (range 3 to 8 months) earlier than that at which elevated CEA was detected. Likewise, in another cohort, elevated serum CEA and positive CTC results were the only two risk factors for postoperative recurrence, with odds ratios of 4.13 and 66.67, respectively [65]. Positive CTCs had higher sensitivity (87.5%) and specificity (92%) in predicting postoperative recurrence than CEA (60.4% and 83.2%, respectively), implying that the presence of CTCs was more powerful for predicting CRC recurrence than elevated CEA.…”