Stool DNA test targeting methylated syndecan-2 (SDC2) as a noninvasive screening method for colorectal cancer

Despite the steadily increasing worldwide incidence of colorectal cancer (CRC), an effective noninvasive approach for early detection of CRC is still under investigation. The guaiac-based fecal occult blood test (FOBT) and fecal immunochemical test (FIT) have gained popularity as noninvasive CRC scr...

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Bibliographic Details
Published in:Bioscience reports 2021-01, Vol.41 (1)
Main Authors: Su, Wei-Chih, Kao, Wei-Yu, Chang, Tsung-Kun, Tsai, Hsiang-Lin, Huang, Ching-Wen, Chen, Yen-Cheng, Li, Ching-Chun, Hsieh, Yi-Chien, Yeh, Hsing-Jung, Chang, Chun-Chao, Wang, Jaw-Yuan
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biomarkers
Cancer
Case-Control Studies
Clinical trials
Colonoscopy
Colorectal cancer
Colorectal carcinoma
Colorectal Neoplasms - diagnosis
Colorectal Neoplasms - pathology
Demographics
Deoxyribonucleic acid
DNA
DNA - analysis
DNA methylation
DNA testing
Epigenetics
Feces
Feces - chemistry
Female
Females
Genetic testing
Health care
Humans
Male
Methylation
Middle Aged
Occult Blood
Patients
Reproducibility of Results
Sensitivity
Sensitivity and Specificity
Statistical analysis
Syndecan
Syndecan-2 - metabolism
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Summary:Despite the steadily increasing worldwide incidence of colorectal cancer (CRC), an effective noninvasive approach for early detection of CRC is still under investigation. The guaiac-based fecal occult blood test (FOBT) and fecal immunochemical test (FIT) have gained popularity as noninvasive CRC screening tests owing to their convenience and relatively low costs. However, the FOBT and FIT have limited sensitivity and specificity. To develop a noninvasive tool for the detection of CRC, we investigated the sensitivity, specificity, and accuracy of a stool DNA test targeting methylated syndecan-2 (SDC2), which is frequently methylated in patients with CRC. The present study enrolled 62 patients diagnosed as having stage 0-IV CRC and 76 healthy participants between July 2018 and June 2019 from two institutions. Approximately 4.5 g of stool sample was collected from each participant for detection of human methylated SDC2 gene. In total, 48 of 62 (77.4%) patients with CRC showed positive results, whereas 67 out of 76 (88.2%) healthy participants showed negative results. The area under the curve of the receiver operating characteristic curve constructed was 0.872 for discrimination between patients with CRC and healthy individuals. The present study highlights the potential of the fecal methylated SDC2 test as a noninvasive detection method for CRC screening with a relatively favorable sensitivity of 77.4%, a specificity of 88.2% and a positive predictive value of 84.2% compared with other available fecal tests. Further multicenter clinical trials comprising subjects of varied ethnicities are required to validate this test for the mass screening of patients with CRC.
ISSN:0144-8463
1573-4935
DOI:10.1042/BSR20201930