Stool screening for colorectal cancer: evolution from occult blood to molecular markers

Ahlquist, David A.; Shuber, Anthony P.

doi:10.1016/s0009-8981(01)00712-4

Cited by 109 publications

(66 citation statements)

References 79 publications

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“…Unfortunately, a variety of issues limits the widespread applicability of colonoscopy (either conventional or virtual) to the screening of asymptomatic patients (3,5,33), a fact that has stimulated the development of noninvasive technologies. One of the most promising of these noninvasive technologies is the analysis of fecal DNA for mutations (34). Because of the frequent presence of mutant DNA molecules in feces from both adenomas and early cancers, fecal DNA analysis is superior to plasma with regard to sensitivity.…”

Section: Discussionmentioning

confidence: 99%

Detection and quantification of mutations in the plasma of patients with colorectal tumors

Diehl

Dressman

et al. 2005

Proc. Natl. Acad. Sci. U.S.A.

1,075

827

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The early detection of cancers through analysis of circulating DNA could have a substantial impact on morbidity and mortality. To achieve this goal, it is essential to determine the number of mutant molecules present in the circulation of cancer patients and to develop methods that are sufficiently sensitive to detect these mutations. Using a modified version of a recently developed assay for this purpose, we found that patients with advanced colorectal cancers consistently contained mutant adenomatous polyposis coli (APC) DNA molecules in their plasma. The median number of APC DNA fragments in such patients was 47,800 per ml of plasma, of which 8% were mutant. Mutant APC molecules were also detected in >60% of patients with early, presumably curable colorectal cancers, at levels ranging from 0.01% to 1.7% of the total APC molecules. These results have implications for the mechanisms through which tumor DNA is released into the circulation and for diagnostic tests based on this phenomenon.colorectal cancer ͉ plasma DNA ͉ tumor suppressor gene ͉ circulating DNA ͉ diagnosis

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Section: Discussionmentioning

confidence: 99%

Detection and quantification of mutations in the plasma of patients with colorectal tumors

Diehl

Dressman

et al. 2005

Proc. Natl. Acad. Sci. U.S.A.

1,075

827

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“…By using Clovera and CEA, it could be possible to identify CRC recurrence before symptoms become apparent, leading to metastasis, By combining biomarker DNA tests with FIT, sensitivity for advanced adenomas can be increased significantly; however, it has lower specificity thus demands more colonoscopy, is more cumbersome, and costly; from refs [41,42,[44][45][46][47]51].…”

Section: Current Methods For Colon Cancer Screeningmentioning

confidence: 99%

MicroRNAs as molecular markers for colon cancer Diagnostic screening in stool & blood

Ahmed¹,

Ahmed²

2017

Med Res Innov

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Screening for colon cancer (CC) allows for diagnosis of the early stage for malignancy and potentially reduces disease mortality as the cancer could be cured at disease earliest stages. Early detection could be desirable if accurate, practical and cost effective diagnostic measures for this cancer are available. Mortality and morbidity from colon cancer represent a major health problem involving a malignant disease that is theoretically preventable through screening. Current screening methods (e.g., the immunological fecal occult blood test, FOBTi, obtained from patients' medical records) either lacks sensitivity and requires dietary restriction, which impedes compliance and use; are costly (e.g., colonoscopy), which decreases compliance; or could lead to mortality. In comparison to the FOBT test, a noninvasive sensitive screen for which there is no requirement for dietary restriction would be a more convenient test. Colorectal cancer (CRC) is the only cancer for which screening by colonoscopy is recommended. Although colonoscopy is a reliable screening tool, its invasive nature, accompanying abdominal pain, potential complications and high cost have hampered the application of this screening method worldwide.A novel screening approach using the stable miRNA molecules, which are relatively nondegradable when extracted from noninvasive stool and semi-invasive blood samples by currently available commercial kits and manipulated thereafter, would be preferable to a transcriptomic messenger (m)RNA-, a mutation DNA-, an epigenetic-or a proteomic-based test. The approach utilizes reverse transcriptase (RT), followed by a modified quantitative real-time polymerase chain reaction (qPCR). Although exosomal RNA would not be measured, using a restricted extraction of total RNA from stool or blood, then a parallel test could also be carried out on RNA obtained from stool or plasma samples, and appropriate corrections for exsosomal loss can be made to obtain accurate and quantitative results. Eventually, a chip would be developed to facilitate diagnosis, as has been carried out for the quantification of genetically modified organisms (GMOs) in foods. The gold standard to which the molecular miRNA test is compared is colonoscopy. If performance criteria are met, as detailed herein, then a miRNA test in human stool or blood samples based on high throughput automated technologies and quantitative expression measurements --commonly used in the diagnostic clinical laboratory--would eventually be advanced to the clinical setting, which will make a vivid impact on the prevention of colon cancer.Correspondence to: Farid E. Ahmed, GEM

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“…Some of these candidate markers express ing mutant DNA are K-ras, APC, p53, Bat-26 and L-DNA. In small studies using a full panel of these five candidate markers a positivity rate of 91 % has been obtained for CRC, 82% for adenomas and 7% for normals [41].…”

Section: Emerging Methodsmentioning

confidence: 99%

“…This is the only CRC screening modality that has been subjeeted to adequately sized randomised controlled trials (RCTs) with longterm follow-up results, using Hemoccult-II [8,10,22,23,31]. Sensitivity for strietly asymptomatic CRC is less than 30% for a single screening round [41], but programme sensitivity has been estimated to be more than 60% [19]. Biennial screening with un-rehydrated Hemoccult-II slides has shown a CRC mortality reduetion of 15-18% after approximately 10 years in the British (Nottingham) and the Danish (Funen) studies (intention-toscreen analysis) [8,10].…”

Section: Performance and Effect Of Crc Screeningmentioning

confidence: 99%

1071 Screening for colorectal cancer

Kronborg¹

2003

European Journal of Cancer Supplements

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Stool screening for colorectal cancer: evolution from occult blood to molecular markers

Cited by 109 publications

References 79 publications

Detection and quantification of mutations in the plasma of patients with colorectal tumors

Detection and quantification of mutations in the plasma of patients with colorectal tumors

MicroRNAs as molecular markers for colon cancer Diagnostic screening in stool & blood

1071 Screening for colorectal cancer

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