Abstract
Objective: Colorectal cancer (CRC) is a significant global health concern with high morbidity and mortality rates. Early detection and accurate diagnostic tools are critical for managing the clinical course. This research explores the molecular landscape of CRC, aiming to provide valuable insights beyond traditional diagnostic approaches. The main aim of this study was to investigate the potential contribution of specific biomarkers, such as secreted frizzled associated protein-4 (sFRP-4), trefoil factor-3 (TFF-3), nuclear factor-kappa-B (NF-κB) and reactive oxygen species modulator-1 (Romo1), to understanding the pathophysiology and determining the progression of CRC.
 Methods: This study analyzed plasma levels of sFRP-4, TFF-3, NF-κB and Romo1 in a cohort of patients with CRC (n=50) and age- and gender-matched control group (n=40), utilizing ELISA. The diagnostic performance of these biomarkers was assessed through Receiver Operating Characteristic (ROC) analysis.
 Results: Our research revealed a significant increase in the levels of NF-κB, TFF-3 and Romo1 in patients with a diagnosis of CRC. Furthermore, these parameters were found to maintain elevated levels in patients with tumors larger than 4 cm as opposed to those with smaller tumors. Patients with metastases also had elevated levels of the three parameters compared with patients without metastases. The ROC analysis revealed that NF-κB showed the most promise as a parameter for distinguishing patients from control subjects, whereas TFF-3 displayed the most potential in identifying tumor size and the presence of metastasis.
 Conclusion: This research contributes valuable insights into understanding the pathophysiology and progression of CRC. The potential roles of NF-κB, TFF-3, and Romo1 as biomarkers, as revealed in our study, offer a promising avenue for early detection and improved management of CRC. Further validation and prospective studies are necessary to clarify the roles of these biomarkers in the pathophysiological mechanism of CRC and to establish their clinical utility.
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