Abstract

Simple SummaryColorectal cancer (CRC) is a significant public health problem, being a major cause of cancer death worldwide. Hence, the identification of biomarkers able to support CRC detection is crucial. This work analyses a panel of six biomarkers, namely interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α), matrix metalloproteinase (MMP)-2, MMP-9, haemoglobin (Hb) and M2-pyruvate kinase (M2-PK), in stool samples from patients with CRC, advanced adenomas, other lesions and healthy individuals. Our results indicate that the levels of Hb and M2-PK were increased in CRC patients in comparison to the controls. Moreover, the combination of these biomarkers increased the specificity or sensitivity for CRC detection and thus present potential for diagnosis of CRC.Background: Colorectal cancer (CRC) is a major cause of cancer-related death worldwide. Cancer progression, including invasion and metastasis, is a major cause of death among CRC patients. Current methods for CRC screening commonly consist of a combination of faecal immunochemical test (FIT) for stool occult blood detection and invasive procedures such as colonoscopy. Considering the slow progression of CRC, and that symptoms usually emerge at advanced stages, its early diagnostic can limit cancer’s spread and provide a successful treatment. Biomarkers have a high potential for the diagnosis of CRC in either blood or stool samples. Methods: In this study, we analysed the diagnostic value of six different biomarkers in stool samples of patients with CRC, advanced adenomas, other lesions and healthy individuals. We have also assessed the overall performance of the combination of these biomarkers for CRC detection. Results: The results indicate that haemoglobin (Hb) and M2-pyruvate kinase (M2-PK) levels were increased in CRC patients in comparison to the controls. Conversely, the concentrations of matrix metalloproteinase (MMP)-2, MMP-9, and tumour necrosis factor-alpha (TNF-α) were not significantly different between the tested groups. Conclusion: The combination of FIT-Hb with the M2-PK levels increased the specificity or sensitivity for CRC detection and thus present potential as faecal diagnostic biomarkers for CRC.

Highlights

  • Colorectal cancer (CRC) is a leading cause of cancer-associated morbidity and mortality worldwide, being the third most frequently diagnosed cancer among adults and one of the leading causes of cancer-related death [1,2]

  • Since the commercial Enzyme-Linked Immunosorbent Assay (ELISA) kits or antibody pairs were not tested for stool samples, we started by optimising the ELISA protocols for these biological samples

  • The results obtained revealed that matrix metalloproteinase (MMP)-2, MMP-9, IL-6, and TNF-α did not offer diagnostic value for CRC

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Summary

Introduction

Colorectal cancer (CRC) is a leading cause of cancer-associated morbidity and mortality worldwide, being the third most frequently diagnosed cancer among adults and one of the leading causes of cancer-related death [1,2]. Most CRC cases occur sporadically and are characterised by a slow progression that involves benign polyps that gradually evolve to invasive and metastasising advanced neoplasms [4,5]. This slow progression makes CRC one of the most preventable diseases; it entirely depends on its early detection, which is challenging, as clinical symptoms usually emerge only when this disease is already advanced [4]. Current methods for CRC screening commonly consist of a combination of faecal immunochemical test (FIT) for stool occult blood detection and invasive procedures such as colonoscopy. Conclusion: The combination of FIT-Hb with the M2-PK levels increased the specificity or sensitivity for CRC detection and present potential as faecal diagnostic biomarkers for CRC

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