Noninvasive Biomarkers of Colorectal Cancer: Role in Diagnosis and Personalised Treatment Perspectives

Abstract

Colorectal cancer (CRC) is the third leading cause of cancer-related deaths worldwide. It has been estimated that more than one-third of patients are diagnosed when CRC has already spread to the lymph nodes. One out of five patients is diagnosed with metastatic CRC. The stage of diagnosis influences treatment outcome and survival. Notwithstanding the recent advances in multidisciplinary management and treatment of CRC, patients are still reluctant to undergo screening tests because of the associated invasiveness and discomfort (e.g., colonoscopy with biopsies). Moreover, the serological markers currently used for diagnosis are not reliable and, even if they were useful to detect disease recurrence after treatment, they are not always detected in patients with CRC (e.g., CEA). Recently, translational research in CRC has produced a wide spectrum of potential biomarkers that could be useful for diagnosis, treatment, and follow-up of these patients. The aim of this review is to provide an overview of the newer noninvasive or minimally invasive biomarkers of CRC. Here, we discuss imaging and biomolecular diagnostics ranging from their potential usefulness to obtain early and less-invasive diagnosis to their potential implementation in the development of a bespoke treatment of CRC.

Novel biomarkers for the diagnosis and prognosis of colorectal cancer

“…Ideally, these aims can be achieved with a noninvasive and inexpensive method using easily available biological samples such as urine, breath, serum, or feces. [6][7][8][9] Despite advances made in recent years, no single test is currently able to diagnose and monitor the posttreatment course of CRC patients. Here, we review the current status of newer diagnostic, prognostic, and predictive biomarkers in CRC and provide insights for their implementation in clinical management.…”

Long non‑coding RNA NKILA serves as a biomarker in the early diagnosis and prognosis of patients with colorectal cancer

“…In addition, it should be able to stratify between different risk-based populations to select patients who require a second-line test, including endoscopic and radiologic investigations. Ideally, this aim can be achieved with a noninvasive and inexpensive method, using readily available biological samples, including serum and feces (37). At present, potential molecular biomarkers for CRC diagnosis are broadly divided into the following four groups: Nucleic acids, cytokines, antibodies and proteins (38).…”

Mast Cells, microRNAs and Others: The Role of Translational Research on Colorectal Cancer in the Forthcoming Era of Precision Medicine

“…miRNAs are a class of short endogenous single-stranded non-coding RNAs that are 18–25 nucleotides in length and are able to post-transcriptionally repress gene expression by binding to the 3′ untranslated region (UTR) of their target mRNAs [ 7 , 55 ].…”

“…miRNAs have been found in different body fluids, such as serum, plasma, urine, saliva, and tissues, where they are stable [ 7 ].…”

“…There are currently three main routes of CRC carcinogenesis: chromosomal instability, DNA replication errors and epigenetic regulation, which includes aberrant hypermethylation and gene silencing [ 3 , 6 , 7 ]. In fact, recent genome-targeting investigations confirmed that each patient is genetically and epigenetically unique [ 8 ].…”