Abstract
Background and study aim: Colorectal cancer (CRC) is a major cause of cancer-related deaths in both men and women. Colonoscopy is the most reliable tool for CRC diagnosis, but its complexity and costs hamper its wide application. There is a pressing need for new non-invasive biomarkers to improve early diagnosis of CRC. Aim was to assess serum micro RNA (miR) -21and miR-92a for diagnosis of CRC. Patients and Methods: This comparative cross sectional study was carried out on 50 subjects. The cases group comprised 35 consecutive treatment naive patients with sporadic CRC proved by colonoscopy and histopathology of the biopsied specimens as well as abdominal CT which all together helped in tumor staging applying TNM, Duke’s and MAC Coller stages. Serum carcinoembryonic antigen (CEA) and cancer antigen (CA) 19-9 were also assessed. Fifteen matched healthy subjects (with normal colonoscopy) served as the control group. Results: Serum levels of miR-21 and miR-92a were significantly higher (P<0.001) in cases compared to the control (5.53 ± 0.17≠4.82 ± 0.20 and 7.01 ± 0.234 ≠ 6.56 ± 0.20 log RU, respectively). Serum miR-21 and miR-92a levels revealed a significantpositive relation with tumor size and TNM and MAC Coller stages (P<0.05). No significant relationship was detected between either serum miR-21 or miR-92a levels with age or sex. Applying ROC curve, at a cutoff value of ≥5.25 log RU, serum miR-21 was 94.3% sensitive and 93.3% specific for detection of CRC with an AUC= 0.99 and serum miR-92a level at a cut off value ≥6.75 log RU, was 91.4% sensitive and 80% specific for detection of CRC with AUC= 0.91. When both markers were combined, the sensitivity and specificity were 97.1% and 93.3% respectively. Conclusion: Serum miR-21 and miR-92a levels represent a sensitive and specific tool for CRC diagnosis, with higher accuracy of miR-21.
Highlights
Colorectal cancer (CRC) is the third most common cancer diagnosed in both men and women [1]
Many studies reported that circulating micro RNA (miR)-92 is a potential biomarker for CRC diagnosis [13,14]
The main presenting symptom in the studied cases was bleeding per rectum (15/35 = 42.9%) followed by recent onset constipation (13/35 = 37.1%) and significant weight loss (7/35 = 20%)
Summary
Colorectal cancer (CRC) is the third most common cancer diagnosed in both men and women [1]. The lifetime risk of developing CRC is about 1 in 21 (4.7%) for men and 1 in 23 (4.4%) for women. The CRC mortality rates can be decreased by early diagnosis through screening. The present CRC screening techniques [colonoscopy, faecal occult blood test (FOBT), and carcinoembryonic antigen (CEA) test] are limited by their difficulties and costs beside uncertain or delayed results [2]. Colonoscopic screening for CRC is the most reliable tool; its difficulties and costs have hampered its wide application. Colorectal cancer (CRC) is a major cause of cancerrelated deaths in both men and women. Colonoscopy is the most reliable tool for CRC diagnosis, but its complexity and costs hamper its wide application. Aim was to assess serum micro RNA (miR) -21and miR-92a for diagnosis of CRC
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