Gene Expression of MicroRNA-205, FGF2 and CARMA3 in Colorectal Cancer in Iraqi Patients.

Toward a Novel Endogenous Anxiolytic Factor, Fibroblast Growth Factor 2

Specific Detection of Cytokeratin 20-Positive Cells in Blood of Colorectal and Breast Cancer Patients by a High Sensitivity Real-Time Reverse Transcriptase-Polymerase Chain Reaction Method

IntroductionPrevious studies demonstrated that MicroRNA-92a (miR-92a) was significantly differential expressed between colorectal cancer (CRC) patients and control cohorts, which provide timely relevant evidence for miR-92a as a novel promising biomarker in the colorectal cancer patients. This meta-analysis aimed to evaluate potential diagnostic value of plasma miR-92a.MethodsRelevant literatures were collected in PubMed, Embase, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI) and Technology of Chongqing (VIP), and Wan Fang Data. Sensitivity, specificity and diagnostic odds ratio (DOR) for miR-92a in the diagnosis of CRC were pooled using random effects models. Summary receiver operating characteristic (SROC) curve analysis and the area under the curve (AUC) were used to estimate the overall test performance.ResultsThis Meta-analysis included six studies with a total of 521 CRC patients and 379 healthy controls. For miR-92a, the pooled sensitivity, specificity and DOR to predict CRC patients were 76% (95% confidence interval [CI]: 72%–79%), 64% (95% confidence interval [CI]: 59%–69%) and 8.05 (95% CI: 3.50–18.56), respectively. In addition, the AUC of miR-92a in diagnosis CRC is 0.7720.ConclusionsMicroRNA-92a might be a novel potential biomarker in the diagnosis of colorectal cancer, and more studies are needed to highlight the theoretical strengths.

Fibroblast growth factor 2: Role in prenatal alcohol-induced stimulation of hypothalamic peptide neurons

Objective To analyze the auxiliary diagnostic value of prostate cancer-associated non-coding RNA transcript1(PCAT-1) in serum of colorectal cancer(CRC) patients. Methods The serum samples were collected from 73 patients with CRC who underwent surgical treatment and were diagnosed by pathology, 54 patients with colorectal polyps and 62 healthy controls at the Affiliated Hospital of Nantong University from October 2015 to January 2017. The serum level of PCAT-1 in CRC patients, colorectal polyps and healthy controls were measured by quantitative real-time polymerase chain reaction, respectively. The relationship between the level of PCAT-1 and the clinical pathologic feature was analyzed. Receiver operating characteristic curve(ROC) was used to evaluate the diagnosis value of PCAT-1, carcinoembryonic antigen(CEA), carbohydrate antigen 199 (CA199) alone and the combination of one of them in CRC. Results The relative expression of PCAT-1 was 2.190 0(0.852 5, 6.715 0), 0.586 5(0.331 8, 1.697 0), 0.530 0(0.127 5, 0.957 5) respectively in CRC patients, colorectal polyps and healthy controls. The expression level of serum PCAT-1 in CRC patients was not related to the age (U=593, P=0.753 3), sex (U=536, P=0.390 8), tumor size (U=549, P=0.557 2) and location (U=584, P=0.426 7), but there was related to the degree of tumor differentiation (U=30, P=0.038 4) and tumor staging (U=399, P=0.005 0). ROC curve was used to analyze the expression of serum PCAT-1, CEA and CA199 for the diagnostic efficiency of CRC. The area under the curve(AUC) of ROC were 0.836, 0.756, 0.493 respectively in comparing CRC patients with healthy controls. The sensitivity of three joint tests was 93.2%(68/73), which was higher than that of single index. The area under the curve of ROC were 0.739, 0.673, and 0.515 respectively in comparing CRC patients with colorectal polyps. The sensitivity of three joint tests was 95.9%(70/73), which was higher than that of single index. Conclusions PCAT-1 maybe has auxiliary diagnosis of CRC. The combination of PCAT-1, CEA and CA199 remarkably improved the diagnostic efficacy of CRC.(Chin J Lab Med, 2018, 41: 514-518) Key words: Colorectal neoplasms; RNA, Long noncoding; Reverse transcriptase polymerase chain reaction

Purpose: Current NCCN guidelines for identifying high-risk stage II/III colorectal cancer (CRC) who may benefit from FOLFOX-based adjuvant chemotherapy remain inadequate. While stage III CRC patients often receive six months of oxaliplatin-based therapy following radical surgery, such treatments are frequently toxic and do not benefit all patients. The use of adjuvant chemotherapy in stage II CRC patients is even more controversial. Hence, identification of high-risk CRC patients with the highest likelihood to benefit from such treatments is of paramount clinical importance. Since microRNAs (miRNAs) have emerged as key functional players and important disease biomarkers, using genomewide miRNA expression profiling, we explored their potential as predictive biomarkers of therapeutic response in CRC. Experimental design: Small RNA-sequencing was performed in a cohort of stage II/III CRC patients who received, at least 6 months of FOLFOX-based therapy (n=71; 30 with recurrence, and 41 without recurrence). Identification of differentially expressed miRNAs was done using DESeq2, and biomarker prioritization using LASSO-Cox's proportional hazards model and AUC (area under the curve) analysis, using recurrence-free survival (RFS) as an outcome. The miRNA-signature was validated by using miRCURY LNA miRNA assays in three, independent patient cohorts of tissue (fresh frozen and FFPE) and serum specimens obtained from stage II/III CRC patients (n=91, 77 and 82, respectively). Univariate and multivariate Cox proportional hazard models were used to evaluate the performance of the miRNA classifier, in conjunction with known clinicopathological risk factors and the microsatellite instability (MSI) status. Results: The small RNA-expression profiling led to the identification of a 13-gene miRNA classifier that significantly predicted recurrence free survival (HR: 2.72, 95% CI: 1.96-3.76, p<0.0001) with an AUC of 0.90 (95% CI: 0.83-0.97). This classifier was successfully validated in two tissue cohorts, with impressive AUCs of 0.78 (95% CI: 0.64-0.90, fresh frozen cohort) and 0.86 (95% CI: 0.69-1.00, FFPE cohort), respectively. Importantly, our miRNA signature yielded an impressive AUC of 0.73 (95% CI: 0.60-0.88), even in the preoperative serum specimens from CRC patients. Multivariate analyses revealed that our miRNA classifier was the only independent predictor of response to FOLFOX-based treatment in stage II and III CRC patients. Conclusions: We report a novel miRNA-based classifier, which robustly predicts response to FOLFOX-based adjuvant chemotherapy in stage II/III CRC patients. Validation of this classifier in pre-operative serum provides an attractive opportunity to explore its potential for disease monitoring during the longitudinal follow-up in CRC patients. Citation Format: Raju Kandimalla, Uthra Balaji, Jinghua Gu, Marta Mendiola, Francesc Balaguer, Luis Bujanda, Joan Maurel, Jaime Feliu, Ajay Goel. Small RNA-sequencing identifies a microRNA signature predictive of response to FOLFOX-based adjuvant therapy in stage II and III colorectal cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4012.

ABSTRACTBackgroundColorectal cancer (CRC) is a prevalent form of cancer globally and ranks as the second most common cause of cancer‐related deaths. Long non‐coding RNAs (lncRNAs) are regulatory RNAs that influence gene expression. EVADR and LUESCC are two novel lncRNAs specifically expressed in tumors of glandular origin, such as the colon.AimsThis study aimed to investigate the expression of EVADR and LUESCC in colorectal tumor tissues and evaluate their potential as diagnostic and prognostic biomarkers in CRC.MethodsFifty cases of colorectal tumor tissues, formalin‐fixed, paraffin‐embedded (FFPE) from individuals with sporadic CRC, referred from the Pathology Department of Imam Hossein Hospital in Tehran, Iran, were analyzed. The expression patterns of LUESCC and EVADR lncRNAs in CRC patients were examined.ResultsThe study reveals upregulation of LUESCC and EVADR lncRNAs in colorectal cancer (CRC) patients compared to normal tissues, with fold changes of 3.52 (p < 0.001) for LUESCC and 3.08 (p < 0.001) for EVADR. ROC curve analysis indicates an area under the curve (AUC) of 0.75 for LUESCC and 0.86 for EVADR, suggesting strong diagnostic potential. Additionally, differential expression analysis shows correlations between lncRNA levels and tumor differentiation grades.ConclusionThis study highlights the potential of LUESCC and EVADR lncRNAs as biomarkers for CRC diagnosis and prognosis. However, limitations include a small sample size that may affect the generalizability of the findings and a lack of functional assays to elucidate their roles in tumor biology. Further research is needed to validate these findings and explore the underlying mechanisms.

Introduction: Prognosis prediction is essential to improve therapeutic strategies and to achieve better clinical outcomes in colorectal cancer (CRC) patients. Radiomics based on high-throughput mining of quantitative medical imaging is an emerging field in recent years. However, the relationship among prognosis, radiomics features, and gene expression remains unknown.Methods: We retrospectively analyzed 141 patients (from study 1) diagnosed with CRC from February 2018 to October 2019 and randomly divided them into training (N = 99) and testing (N = 42) cohorts. Radiomics features in venous phase image were extracted from preoperative computed tomography (CT) images. Gene expression was detected by RNA-sequencing on tumor tissues. The least absolute shrinkage and selection operator (LASSO) regression model was used for selecting imaging features and building the radiomics model. A total of 45 CRC patients (study 2) with immunohistochemical (IHC) staining of CXCL8 diagnosed with CRC from January 2014 to October 2018 were included in the independent testing cohort. A clinical model was validated for prognosis prediction in prognostic testing cohort (163 CRC patients from 2014 to 2018, study 3). We performed a combined radiomics model that was composed of radiomics score, tumor stage, and CXCL8-derived radiomics model to make comparison with the clinical model.Results: In our study, we identified the CXCL8 as a hub gene in affecting prognosis, which is mainly through regulating cytokine–cytokine receptor interaction and neutrophil migration pathway. The radiomics model incorporated 12 radiomics features screened by LASSO according to CXCL8 expression in the training cohort and showed good performance in testing and IHC testing cohorts. Finally, the CXCL8-derived radiomics model combined with tumor stage performed high ability in predicting the prognosis of CRC patients in the prognostic testing cohort, with an area under the curve (AUC) of 0.774 [95% confidence interval (CI): 0.674–0.874]. Kaplan–Meier analysis of the overall survival probability in CRC patients stratified by combined model revealed that high-risk patients have a poor prognosis compared with low-risk patients (Log-rank P < 0.0001).Conclusion: We demonstrated that the radiomics model reflected by CXCL8 combined with tumor stage information is a reliable approach to predict the prognosis in CRC patients and has a potential ability in assisting clinical decision-making.

For many decades, cell-free nucleic acids have been known to be present in peripheral blood. Several studies have identified tumor-specific and/or tumor-associated alterations in the circulating nucleic acids of patients with various cancers. In recent years, cell-free microRNA (miRNA) have been stably detected in the plasma and serum, like other molecules; their presence in the blood has attracted the attention of researchers due to their potential use as valuable blood biomarkers.1Schwarzenbach H. Hoon D.S. Pantel K. Cell-free nucleic acids as biomarkers in cancer patients.Nat Rev Cancer. 2011; 11: 426-437Crossref PubMed Scopus (2199) Google Scholar MiRNAs are short, noncoding RNAs that play important roles in various physiologic and developmental processes. The mature miRNAs are produced from long primary transcripts through 2 sequential cleavage steps. The long primary miRNA transcript is cleaved by the Drosha complex in the nucleus, generating intermediate precursor miRNA. Precursor miRNA is transported by exportin-5 from the nucleus into the cytoplasm, and then subjected to further cleavage by a Dicer RNAase III enzyme, generating a short double-strand miRNA. One strand (guided strand) of mature miRNA is then incorporated into the RNA-induced silencing complex and subsequently hybridize to the 3′-untranslated region of their target mRNAs to repress translation or degrade these mRNAs. Thus, a single miRNA can influence the expression of hundreds of genes and allow them to function in a coordinated manner. Therefore, miRNAs have been implicated as key molecules in all cellular processes. Numerous studies have shown that alterations in miRNA expression correlate with various diseases, including the development and progression of cancer, and some miRNAs can function as oncogenes or tumor suppressors. These findings have opened up a new and interesting field in the diagnosis of cancer and the treatments of cancer patients. Mitchell et al2Mitchell P.S. Parkin R.K. Kroh E.M. et al.Circulating microRNAs as stable blood-based markers for cancer detection.Proc Natl Acad Sci U S A. 2008; 105: 10513-10518Crossref PubMed Scopus (6792) Google Scholar first demonstrated that circulating miRNAs had the potential to be new biomarkers in patients with solid cancers. In recent years, several papers have demonstrated that circulating miRNAs can also be detected in the peripheral blood of patients with digestive tract cancers. Although the origins and physiologic functions of cell-free miRNAs in the blood remain to be fully elucidated, a noninvasive assay for miRNAs should be developed to exploit these molecules as potential diagnostic and prognostic biomarkers. This assay undoubtedly contributes to an improvement in the clinical outcomes of cancer patients. In this article, we review the current state of biological and clinical research regarding circulating miRNAs of digestive tract cancer patients and discuss the future perspectives. It has been theorized that the necrosis and the apoptosis of tumor cells are the main sources of cell-free nucleic acids in the plasma and serum. However, several recent studies have demonstrated that extracellular nucleic acids, especially miRNAs, occur not only through cell lysis but also through active secretion.1Schwarzenbach H. Hoon D.S. Pantel K. Cell-free nucleic acids as biomarkers in cancer patients.Nat Rev Cancer. 2011; 11: 426-437Crossref PubMed Scopus (2199) Google Scholar, 3Valadi H. Ekström K. Bossios A. et al.Exosome-mediated transfer of mRNAs and microRNAs is a novel mechanism of genetic exchange between cells.Nat Cell Biol. 2007; 9: 654-659Crossref PubMed Scopus (9739) Google Scholar, 4Kosaka N. Iguchi H. Yoshioka Y. et al.Secretory mechanisms and intercellular transfer of microRNAs in living cells.J Biol Chem. 2010; 285: 17442-17452Abstract Full Text Full Text PDF PubMed Scopus (1591) Google Scholar, 5Pigati L. Yaddanapudi S.C. Iyengar R. et al.Selective release of microRNA species from normal and malignant mammary epithelial cells.PLoS One. 2010; 5: e13515Crossref PubMed Scopus (497) Google Scholar Cell-derived endogenous miRNAs are present in the blood in a remarkably stable form that is protected from endogenous RNase activity. In contrast, synthetic exogenous miRNAs are rapidly degraded when added directly to the plasma.2Mitchell P.S. Parkin R.K. Kroh E.M. et al.Circulating microRNAs as stable blood-based markers for cancer detection.Proc Natl Acad Sci U S A. 2008; 105: 10513-10518Crossref PubMed Scopus (6792) Google Scholar Kosaka et al4Kosaka N. Iguchi H. Yoshioka Y. et al.Secretory mechanisms and intercellular transfer of microRNAs in living cells.J Biol Chem. 2010; 285: 17442-17452Abstract Full Text Full Text PDF PubMed Scopus (1591) Google Scholar clearly demonstrated that a subset of miRNAs was packaged into exosome vesicles and released through a ceramide-dependent secretory mechanism. Arroyo et al6Arroyo J.D. Chevillet J.R. Kroh E.M. et al.Argonaute2 complexes carry a population of circulating microRNAs independent of vesicles in human plasma.Proc Natl Acad Sci U S A. 2011; 108: 5003-5008Crossref PubMed Scopus (2672) Google Scholar systematically investigated circulating miRNAs in the plasma and serum using differential centrifugation and size-exclusion chromatography techniques. This group demonstrated ≥2 populations of circulating miRNAs in the plasma and serum and discovered agonaute-2, a key effector protein involved in miRNA-mediated silencing as an miRNA carrier in the blood.6Arroyo J.D. Chevillet J.R. Kroh E.M. et al.Argonaute2 complexes carry a population of circulating microRNAs independent of vesicles in human plasma.Proc Natl Acad Sci U S A. 2011; 108: 5003-5008Crossref PubMed Scopus (2672) Google Scholar In addition, high-density lipoprotein has been described as an alternative transporter of extracellular miRNAs in human plasma.7Vickers K.C. Palmisano B.T. Shoucri B.M. et al.MicroRNAs are transported in plasma and delivered to recipient cells by high-density lipoproteins.Nat Cell Biol. 2011; 13: 423-433Crossref PubMed Scopus (2256) Google Scholar All circulating miRNAs, regardless of whether they are incorporated into protein complexes and/or cell-derived microvesicles, seem to be adequately protected against the degradation caused by the abundant RNases in human plasma and serum. Indeed, the extracellular miRNAs in the plasma and serum are extremely stable under severe conditions, such as extended storage and exposure to multiple freeze–thaw cycles.2Mitchell P.S. Parkin R.K. Kroh E.M. et al.Circulating microRNAs as stable blood-based markers for cancer detection.Proc Natl Acad Sci U S A. 2008; 105: 10513-10518Crossref PubMed Scopus (6792) Google Scholar Regarding the composition of circulating miRNAs, Pigati et al5Pigati L. Yaddanapudi S.C. Iyengar R. et al.Selective release of microRNA species from normal and malignant mammary epithelial cells.PLoS One. 2010; 5: e13515Crossref PubMed Scopus (497) Google Scholar investigated the difference between extracellular and cellular miRNAs using epithelial cell lines and concluded that the release of miRNAs did not necessarily reflect the abundance of miRNAs in the cell of origin. Kosaka et al4Kosaka N. Iguchi H. Yoshioka Y. et al.Secretory mechanisms and intercellular transfer of microRNAs in living cells.J Biol Chem. 2010; 285: 17442-17452Abstract Full Text Full Text PDF PubMed Scopus (1591) Google Scholar also demonstrated that some specific miRNAs were expressed to a greater extent in cell-derived exosomes compared with their donor cells.4Kosaka N. Iguchi H. Yoshioka Y. et al.Secretory mechanisms and intercellular transfer of microRNAs in living cells.J Biol Chem. 2010; 285: 17442-17452Abstract Full Text Full Text PDF PubMed Scopus (1591) Google Scholar Moreover, other groups demonstrated that the non–vesicle-associated miRNA profiles within protein complexes were distinctly different from the purified, exosomes-associated miRNA profiles.6Arroyo J.D. Chevillet J.R. Kroh E.M. et al.Argonaute2 complexes carry a population of circulating microRNAs independent of vesicles in human plasma.Proc Natl Acad Sci U S A. 2011; 108: 5003-5008Crossref PubMed Scopus (2672) Google Scholar These findings indicate that intracellular miRNAs are exported to the extracellular environment through a selective secretion mechanism. Interestingly, recent studies have demonstrated that extracellular miRNAs not only circulate in stable forms, but can also be incorporated into other surrounding and distant recipient cells in which they fulfill distinctive functions.8Skog J. Würdinger T. van Rijn S. et al.Glioblastoma microvesicles transport RNA and proteins that promote tumour growth and provide diagnostic biomarkers.Nat Cell Biol. 2008; 10: 1470-1476Crossref PubMed Scopus (3954) Google Scholar, 9Rechavi O. Erlich Y. Amram H. et al.Cell contact–dependent acquisition of cellular and viral nonautonomously encoded small RNAs.Genes Dev. 2009; 23: 1971-1979Crossref PubMed Scopus (100) Google Scholar, 10Zernecke A. Bidzhekov K. Noels H. et al.Delivery of microRNA-126 by apoptotic bodies induces CXCL12-dependent vascular protection.Sci Signal. 2009; 2: ra81Crossref PubMed Scopus (1130) Google Scholar, 11Kosaka N. Iguchi H. Ochiya T. Circulating microRNA in body fluid: a new potential biomarker for cancer diagnosis and prognosis.Cancer Sci. 2010; 101: 2087-2092Crossref PubMed Scopus (1144) Google Scholar, 12Pegtel D.M. Cosmopoulos K. Thorley–Lawson D.A. et al.Functional delivery of viral miRNAs via exosomes.Proc Natl Acad Sci U S A. 2010; 107: 6328-6333Crossref PubMed Scopus (1309) Google Scholar, 13Kosaka N. Iguchi H. Yoshioka Y. et al.Competitive Interactions of Cancer Cells and Normal Cells via Secretory MicroRNAs.J Biol Chem. 2012; 287: 1397-1405Abstract Full Text Full Text PDF PubMed Scopus (235) Google Scholar Rechavi et al9Rechavi O. Erlich Y. Amram H. et al.Cell contact–dependent acquisition of cellular and viral nonautonomously encoded small RNAs.Genes Dev. 2009; 23: 1971-1979Crossref PubMed Scopus (100) Google Scholar demonstrated that functional signals spread across cell boundaries between immune cells in a contact-dependent manner. Pegtel et al12Pegtel D.M. Cosmopoulos K. Thorley–Lawson D.A. et al.Functional delivery of viral miRNAs via exosomes.Proc Natl Acad Sci U S A. 2010; 107: 6328-6333Crossref PubMed Scopus (1309) Google Scholar reported that Epstein–Barr virus miRNAs were secreted from infected B cells and were present in both the circulation and noninfected non-B cells. This group also demonstrated that miRNAs were transferred from infected to noninfected cells in vivo and were functional (upon transfer via exosomes) in primary monocyte-derived dendritic cells. Other groups have shown that miR-126 in apoptotic bodies derived from atherosclerotic endothelial cells induces the CXCL-12–dependent vascular protection process in recipient vascular cells.10Zernecke A. Bidzhekov K. Noels H. et al.Delivery of microRNA-126 by apoptotic bodies induces CXCL12-dependent vascular protection.Sci Signal. 2009; 2: ra81Crossref PubMed Scopus (1130) Google Scholar There have also been some reports regarding miRNA-mediated intercellular communication in a neoplastic environment. Skog et al8Skog J. Würdinger T. van Rijn S. et al.Glioblastoma microvesicles transport RNA and proteins that promote tumour growth and provide diagnostic biomarkers.Nat Cell Biol. 2008; 10: 1470-1476Crossref PubMed Scopus (3954) Google Scholar reported that microvesicles that housed miRNAs derived from glioblastomas were taken up by and fulfilled functions in human brain microvascular endothelial cells in culture. Kosaka et al4Kosaka N. Iguchi H. Yoshioka Y. et al.Secretory mechanisms and intercellular transfer of microRNAs in living cells.J Biol Chem. 2010; 285: 17442-17452Abstract Full Text Full Text PDF PubMed Scopus (1591) Google Scholar also demonstrated that miR-146a, which is a tumor-suppressive miRNA in prostate cancer, significantly knocked down the target ROCK1 protein expression and decreased cell proliferation in a recipient prostate cancer cell line.4Kosaka N. Iguchi H. Yoshioka Y. et al.Secretory mechanisms and intercellular transfer of microRNAs in living cells.J Biol Chem. 2010; 285: 17442-17452Abstract Full Text Full Text PDF PubMed Scopus (1591) Google Scholar Their subsequent paper demonstrated that a variety of tumor-suppressive miRNAs were secreted by a normal adult prostatic epithelial cell line, and among these secretory miRNAs, miR-143 could inhibit growth exclusively in cancer cells both in vitro and in vivo.13Kosaka N. Iguchi H. Yoshioka Y. et al.Competitive Interactions of Cancer Cells and Normal Cells via Secretory MicroRNAs.J Biol Chem. 2012; 287: 1397-1405Abstract Full Text Full Text PDF PubMed Scopus (235) Google Scholar Other groups found that the let-7 miRNA family was abundant in the extracellular fractions derived from a metastatic gastric cancer (GC) cell line, but not those derived from a low metastatic parental cell line, and it has been speculated that some cancer cells maintain their oncogenesis via specific extracellular miRNAs.14Ohshima K. Inoue K. Fujiwara A. et al.Let-7 microRNA family is selectively secreted into the extracellular environment via exosomes in a metastatic gastric cancer cell line.PLoS One. 2010; 5: e13247Crossref PubMed Scopus (515) Google Scholar On the other hand, exosomes released from neoplastic cells have been reported to suppress immune surveillance, and cell-free miRNAs contained within the exosomes may be responsible for the immunosuppression systems.15Zhang H.G. Grizzle W.E. Exosomes and cancer: a newly described pathway of immune suppression.Clin Cancer Res. 2011; 17: 959-964Crossref PubMed Scopus (233) Google Scholar These findings support the presence of miRNA-mediated intercellular communication in the normal cellular environment and the tumor environment (Figure 1) . Several methods can be used for extracting miRNAs; however, efficient protocols with high reproducibility should be utilized for the extraction of circulating miRNAs owing to the small amounts present in the plasma and serum. Commercial extraction kits that utilize glass fiber filters in the purification process have been widely used for clinical blood samples, and there are several methods for quantification. A polymerase chain reaction (PCR)-based technique using a stem-loop reverse-transcriptase (RT) primer has been widely used for determining quantity. A microarray assay, which can analyze hundreds of miRNAs simultaneously, has also been utilized for the identification of a specific marker among many circulating miRNAs. Recent advances in technology allow for the use of an oligonucleotide array to quantify the amount of circulating miRNAs without the need for PCR. Most recently, researchers have identified circulating miRNAs as new diagnostic markers in patients with cancer using direct sequencing methods16Brase J.C. Wuttig D. Kuner R. et al.Serum microRNAs as non–invasive biomarkers for cancer.Mol Cancer. 2010; 9: 306Crossref PubMed Scopus (366) Google Scholar (Table 117Zhang C. Wang C. Chen X. et al.Expression profile of microRNAs in serum: a fingerprint for esophageal squamous cell carcinoma.Clin Chem. 2010; 56: 1871-1879Crossref PubMed Scopus (289) Google Scholar, 18Komatsu S. Ichikawa D. Takeshita H. et al.Circulating microRNAs in plasma of patients with oesophageal squamous cell carcinoma.Br J Cancer. 2011; 105: 104-111Crossref PubMed Scopus (233) Google Scholar, 19Tsujiura M. Ichikawa D. Komatsu S. et al.Circulating microRNAs in plasma of patients with gastric cancers.Br J Cancer. 2010; 102: 1174-1179Crossref PubMed Scopus (578) Google Scholar, 20Liu R. Zhang C. Hu Z. et al.A five-microRNA signature identified from genome–wide serum microRNA expression profiling serves as a fingerprint for gastric cancer diagnosis.Eur J Cancer. 2011; 47: 784-791Abstract Full Text Full Text PDF PubMed Scopus (392) Google Scholar, 21Liu H. Zhu L. Liu B. et al.Genome-wide microRNA profiles identify miR-–378 as a serum biomarker for early detection of gastric cancer.Cancer Lett. 2012; 316: 196-203Crossref PubMed Scopus (234) Google Scholar, 22Konishi H. Ichikawa D. Komatsu S. et al.Detection of gastric cancer–associated microRNAs on microRNA microarray comparing pre- and post-operative plasma.Br J Cancer. 2012; 106: 740-747Crossref PubMed Scopus (165) Google Scholar, 23Ng E.K. Chong W.W. Jin H. et al.Differential expression of microRNAs in plasma of patients with colorectal cancer: a potential marker for colorectal cancer screening.Gut. 2009; 58: 1375-1381Crossref PubMed Scopus (1055) Google Scholar, 24Huang Z. Huang D. Ni S. et al.Plasma microRNAs are promising novel biomarkers for early detection of colorectal cancer.Int J Cancer. 2010; 127: 118-126Crossref PubMed Scopus (868) Google Scholar, 25Wang L.G. Gu J. Serum is a promising novel marker for early detection of colorectal 2012; PubMed Scopus Google Scholar, H. 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Chen J. et al.MicroRNAs in plasma of patients as novel blood-based biomarkers of Res. 2009; 2: PubMed Scopus Google Scholar, A. N. et and and in with circulating and Res. 2010; PubMed Scopus Google Scholar, Huang X. H. et al.Circulating as a novel marker in 2010; PubMed Scopus Google Scholar, S. K. Chen et expressed miRNAs in the plasma may provide a signature for J Res. 2010; Google Scholar, N. A. et and serum microRNAs in the and in patients with One. 2011; PubMed Scopus Google Scholar, R. Komatsu S. Ichikawa D. et diagnostic of circulating in plasma of patients with J Cancer. 2011; 105: PubMed Scopus Google Scholar, J. J. Y. et of plasma microRNAs with serum for early detection of cancer.Int J Cancer. 2011; Scopus Google miRNAs in cell or other C. Wang C. Chen X. et al.Expression profile of microRNAs in serum: a fingerprint for esophageal squamous cell carcinoma.Clin Chem. 2010; 56: 1871-1879Crossref PubMed Scopus (289) Google S. Ichikawa D. Takeshita H. et al.Circulating microRNAs in plasma of patients with oesophageal squamous cell carcinoma.Br J Cancer. 2011; 105: 104-111Crossref PubMed Scopus (233) Google M. Ichikawa D. Komatsu S. et al.Circulating microRNAs in plasma of patients with gastric cancers.Br J Cancer. 2010; 102: 1174-1179Crossref PubMed Scopus (578) Google or other R. Zhang C. Hu Z. et al.A five-microRNA signature identified from genome–wide serum microRNA expression profiling serves as a fingerprint for gastric cancer diagnosis.Eur J Cancer. 2011; 47: 784-791Abstract Full Text Full Text PDF PubMed Scopus (392) Google in the H. Zhu L. Liu B. et al.Genome-wide microRNA profiles identify miR-–378 as a serum biomarker for early detection of gastric cancer.Cancer Lett. 2012; 316: 196-203Crossref PubMed Scopus (234) Google H. Ichikawa D. Komatsu S. et al.Detection of gastric cancer–associated microRNAs on microRNA microarray comparing pre- and post-operative plasma.Br J Cancer. 2012; 106: 740-747Crossref PubMed Scopus (165) Google E.K. Chong W.W. Jin H. et al.Differential expression of microRNAs in plasma of patients with colorectal cancer: a potential marker for colorectal cancer screening.Gut. 2009; 58: 1375-1381Crossref PubMed Scopus (1055) Google Z. Huang D. Ni S. et al.Plasma microRNAs are promising novel biomarkers for early detection of colorectal cancer.Int J Cancer. 2010; 127: 118-126Crossref PubMed Scopus (868) Google in the L.G. Gu J. Serum is a promising novel marker for early detection of colorectal 2012; PubMed Scopus Google cancer H. Zhang L. et al.Circulating plasma is a novel biomarker for metastatic cancer and One. 2011; PubMed Scopus Google in the Huang et al.Circulating directly from plasma is a potential diagnostic and prognostic marker of colorectal cancer and is with 2010; PubMed Scopus Google in the Y. Kosaka N. M. et as a potential diagnostic marker for 2009; PubMed Scopus Google Zhang K. H. et al.Circulating microRNAs as biomarkers for 2011; PubMed Scopus Google Wang H. et al.Serum as for in with B One. 2011; PubMed Scopus Google not for J. C. X. et al.Circulating and in patients with or 2011; PubMed Scopus Google in the J. L. X. Hu J. et al.Plasma to 2011; PubMed Scopus Google Y. H. H. et al.Circulating as a novel biomarker for 2012; 56: Full Text Full Text PDF PubMed Scopus Google J. Y. X. et al.Serum microRNA as a potential marker for Sci. 2011; PubMed Scopus Google in the J. Chen J. et al.MicroRNAs in plasma of patients as novel blood-based biomarkers of Res. 2009; 2: PubMed Scopus Google A. N. et and and in with circulating and Res. 2010; PubMed Scopus Google in the Huang X. H. et al.Circulating as a novel marker in 2010; PubMed Scopus Google S. K. Chen et expressed miRNAs in the plasma may provide a signature for J Res. 2010; Google N. A. et and serum microRNAs in the and in patients with One. 2011; PubMed Scopus Google R. Komatsu S. Ichikawa D. et diagnostic of circulating in plasma of patients with J Cancer. 2011; 105: PubMed Scopus Google in the J. J. Y. et of plasma microRNAs with serum for early detection of cancer.Int J Cancer. 2011; Scopus Google microRNA colorectal direct esophageal gastric polymerase chain in the in a new microRNA colorectal direct esophageal gastric polymerase chain Zhang et C. Wang C. Chen X. et al.Expression profile of microRNAs in serum: a fingerprint for esophageal squamous cell carcinoma.Clin Chem. 2010; 56: 1871-1879Crossref PubMed Scopus (289) Google Scholar have investigated the serum miRNA profiles of patients with esophageal squamous cell using miRNAs using direct this group identified serum miRNAs and as biomarkers. The under the for the miRNAs were for serum tumor and patients in the early of the could be from using the miRNA C. Wang C. Chen X. et al.Expression profile of microRNAs in serum: a fingerprint for esophageal squamous cell carcinoma.Clin Chem. 2010; 56: 1871-1879Crossref PubMed Scopus (289) Google Scholar plasma from group also the plasma expression of miRNAs that were to be with the development of on found that the plasma of to be in patients in the and the were significantly in compared with A of the in plasma was the of an in serum tumor which that circulating miRNAs may be for diagnosis of in S. Ichikawa D. Takeshita H. et al.Circulating microRNAs in plasma of patients with oesophageal squamous cell carcinoma.Br J Cancer. 2011; 105: 104-111Crossref PubMed Scopus (233) Google Scholar However, there have been reports regarding circulating miRNAs for the other group first reported the of circulating miRNAs as biomarkers in patients with miRNAs and which have been reported to be in as miRNAs and their in plasma using In the plasma of these miRNAs the tumor miRNA and were significantly in patients in the also found that the plasma of these miRNAs were significantly in compared with M. Ichikawa D. Komatsu S. et al.Circulating microRNAs in plasma of patients with gastric cancers.Br J Cancer. 2010; 102: 1174-1179Crossref PubMed Scopus (578) Google Scholar Liu et R. Zhang C. 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This study aimed to explore the role of plasma methylated SEPT9 (mSEPT9) in predicting liver metastasis (LM) in colorectal cancer (CRC) patients. The clinicopathological information of 115 consecutive CRC patients were collected. The differences of clinical characteristics and several biomarkers between CRC patients with LM and those with non-liver metastasis (NM) were analyzed. Multivariate logistic regression analysis was used to identify the risk factors for predicting LM in CRC patients. Receiver operating characteristic curve (ROC) analysis was applied to investigate the sensitivity and specificity of potential biomarkers in indicating the presence of LM in CRC. Compared with the CRC without LM, the levels of plasma mSEPT9 and carcinoembryonic antigen (CEA) were significantly increased in CRC with LM. Multivariate logistic regression analysis showed that plasma mSEPT9 was an independent risk factor for predicting LM in CRC. ROC curves showed that mSEPT9 and CEA could efficiently distinguish LM from NM in CRC. The area under the curve (AUC) of mSEPT9 was 0.850, which was slightly higher than that of CEA (0.842). The optimal cut-off value of mSEPT9 was 35.09 with a sensitivity of 81.82% and a specificity of 73.33%, both similar with that of CEA (sensitivity 87.27% and specificity 75.00%). In addition, the combination of mSEPT9 and CEA had a higher specificity than CEA alone (81.70% Vs 75.00%). Our findings suggest, for the first time, that plasma mSEPT9 might serve as a potential biomarker to predict LM in CRC, which deserves further in-depth study.

Colorectal cancer (CRC) prognosis is determined by the disease stage with low survival rates for advanced stages. Current CRC screening programs are mainly using colonoscopy, limited by its invasiveness and high cost. Therefore, non-invasive, cost-effective, and accurate alternatives are urgently needed. This retrospective multi-center plasma proteomics study was performed to identify potential blood-based biomarkers in 36 CRC patients and 26 healthy volunteers by high-resolution mass spectrometry proteomics followed by the validation in an independent CRC cohort (60 CRC patients and 44 healthy subjects) of identified selected biomarkers. Among the 322 identified plasma proteins, 37 were changed between CRC patients and healthy volunteers and were associated with the complement cascade, cholesterol metabolism, and SERPIN family members. Increased levels in CRC patients of the complement proteins C1QB, C4B, and C5 as well as pro-inflammatory proteins, lipopolysaccharide-binding protein (LBP) and serum amyloid A4, constitutive (SAA4) were revealed for first time. Importantly, increased level of C5 was verified in an independent validation CRC cohort. Increased C4B and C8A levels were correlated with cancer-associated inflammation and CRC progression, while cancer-associated inflammation was linked to the acute-phase reactant leucine-rich alpha-2-glycoprotein 1 (LRG1) and ceruloplasmin. Moreover, a 4-protein signature including C4B, C8A, apolipoprotein C2 (APO) C2, and immunoglobulin heavy constant gamma 2 was changed between early and late CRC stages. Our results suggest that C5 could be a potential biomarker for CRC diagnosis. Further validation studies will aid the application of these new potential biomarkers to improve CRC diagnosis and patient care.

3613 Background: Colorectal cancer (CRC) is the third most prevalent and the second deadliest cancer globally, accounting for an estimated 1,926,000 new cases and 903,800 deaths in the year 2022 alone. It's also established that chronic inflammatory conditions, such as Crohn's disease and ulcerative colitis, elevate the risk of developing CRC. Therefore, a timely CRC diagnosis for patients with colorectal disease can significantly improve their prognosis and therefore reduce cancer-related mortalities. Methods: In this study, we enrolled a total of 167 patients diagnosed with CRC (stages I: 43, II: 55, III: 56, IV: 13) and 217 patients with benign colorectal disease (BCD), from five participating hospitals. All participants underwent colonoscopy procedures, and their CRC or BCD status was pathologically confirmed. The development of the cancer detection model was based on a training cohort of 98 CRC patients and 131 BCD patients from three hospitals, and the evaluation of the model's performance was carried out on an independent test cohort comprising 69 CRC patients and 96 BCD patients from the remaining two hospitals. The predictive model leveraged cell-free fragmentomics profiling, employing low-pass whole-genome sequencing (WGS) on pre-operative plasma samples to identify CRC. Results: The early detection model exhibited remarkable efficacy in differentiating CRC patients from those with BCD, achieving an Area Under the Curve (AUC) of 0.930 in the training cohort and a nearly equivalent AUC of 0.926 in the independent test cohort. By applying the same cutoff determined in the training cohort, our model demonstrated a high sensitivity (91.8% in the training cohort and 91.3% in the test cohort) and a satisfactory specificity (78.6% in the training cohort and 82.3% in the test cohort). Notably, the model showed consistent and robust performance across various CRC characteristics, including tumor location, histology subtypes, grades, and mismatch repair deficiency status in both cohorts. Moreover, our model outperformed traditional CRC screening methods such as the fecal immunochemical test, carcinoembryonic antigen (CEA), and CA19-9, which achieved AUCs of 0.742, 0.720, and 0.543, respectively. Further validation was conducted using an additional cohort of 31 patients with advanced colorectal adenoma (advCRA), where the model achieved an AUC of 0.846 and a 66.7% sensitivity for distinguishing advCRA from BCD. Conclusions: The study introduces a non-invasive, cell-free fragmentomics assay that incorporates low-pass WGS and machine learning algorithms, demonstrating significant clinical potential in accurately distinguishing CRC and BCD patients. Our innovative approach offers a promising alternative to traditional screening methods that can improve early CRC detection, enhance CRC patient outcomes, and reduce mortality rates.

Quantification of Intratumoral Heterogeneity Based on Habitat Analysis for Preoperative Assessment of Lymphovascular Invasion in Colorectal Cancer.

BackgroundUnderstanding the metabolic changes in colorectal cancer (CRC) and exploring potential diagnostic biomarkers is crucial for elucidating its pathogenesis and reducing mortality. Cancer cells are typically derived from cancer tissues and can be easily obtained and cultured. Systematic studies on CRC cells at different stages are still lacking. Additionally, there is a need to validate our previous findings from human serum.MethodsUltrahigh-performance liquid chromatography tandem high-resolution mass spectrometry (UHPLC-HRMS)-based metabolomics and lipidomics were employed to comprehensively measure metabolites and lipids in CRC cells at four different stages and serum samples from normal control (NR) and CRC subjects. Univariate and multivariate statistical analyses were applied to select the differential metabolites and lipids between groups. Biomarkers with good diagnostic efficacy for CRC that existed in both cells and serum were screened by the receiver operating characteristic curve (ROC) analysis. Furthermore, potential biomarkers were validated using metabolite standards.ResultsMetabolite and lipid profiles differed significantly among CRC cells at stages A, B, C, and D. Dysregulation of glycerophospholipid (GPL), fatty acid (FA), and amino acid (AA) metabolism played a crucial role in the CRC progression, particularly GPL metabolism dominated by phosphatidylcholine (PC). A total of 46 differential metabolites and 29 differential lipids common to the four stages of CRC cells were discovered. Eight metabolites showed the same trends in CRC cells and serum from CRC patients compared to the control groups. Among them, palmitoylcarnitine and sphingosine could serve as potential biomarkers with the values of area under the curve (AUC) more than 0.80 in the serum and cells. Their panel exhibited excellent performance in discriminating CRC cells at different stages from normal cells (AUC = 1.00).ConclusionsTo our knowledge, this is the first research to attempt to validate the results of metabolism studies of serum from CRC patients using cell models. The metabolic disorders of PC, FA, and AA were closely related to the tumorigenesis of CRC, with PC being the more critical factor. The panel composed of palmitoylcarnitine and sphingosine may act as a potential biomarker for the diagnosis of CRC, aiding in its prevention.

Integrated molecular analysis demonstrated that colorectal cancer can be classified into four molecular subtypes (proliferative, immunomodulatory, immunosuppressed, and immune-excluded subtypes), providing valuable insight into the intricate relationship between tumor microenvironment heterogeneity and various clinical phenotypes.