Abstract

microRNAs (miRNA) are promising predictors in colorectal cancer (CRC). We investigated whether miRNAs could predict adenoma recurrence in patients with advanced colorectal adenoma (ACRA) after polypectomy. miRNA expression profiling was performed by miRNA microarray to identify recurrence-related miRNAs. Candidate miRNAs extracted from formalin-fixed paraffin-embedded blocks of patients with ACRA were measured using real-time PCR. Logistic regression analysis was conducted to investigate whether validated miRNA expression profiles were independent from other known adenoma recurrence risk factors. The prognostic values of six miRNAs and three independent risk factors were assessed by the area under the receiver operating characteristic (ROC) curve analysis. The expressions of six candidate miRNAs were significantly decreased from levels in normal colorectal tissue compared with ARCA with adenoma recurrence (RACRA) in this retrospective cohort. However, only miRNA (miR)-194 emerged as a practical predictor. The sensitivity and specificity of miR-194 as a predictor were 71.0% and 78.0%, respectively, at a cutoff value of 0.1311 in the retrospective cohort. Sensitivity and specificity were 76.1% and 77.2%, respectively, in the prospective cohort using the same cutoff value. Low expression levels of miR-194, adenoma size ≥2 cm, and ≥3 adenomas were independent risk factors for adenoma recurrence. Moreover, low expression of miR-194 was a better predictor of adenoma recurrence than the adenoma size and numbers according to ROC curve analysis. miR-194 may be an independent predictor for adenoma recurrence in patients with ACRA after polypectomy.

Highlights

  • Advanced colorectal adenomas (ACRA) are precursors of colorectal cancer (CRC), and their removal is central for reducing incidence and mortality rates [1]

  • Formalin-fixed paraffin-embedded (FFPE) samples were obtained from 37 healthy volunteers and 227 patients with advanced colorectal adenoma (ACRA) who underwent polypectomy from a retrospective cohort recruited at Renji Hospital (Shanghai, China), in addition to 158 patients with ACRA after polypectomy in prospective cohort at Shanghai 1st Hospital

  • Recognition of adenoma recurrence after ACRA polypectomy is the key to reducing the incidence of CRC

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Summary

Introduction

Advanced colorectal adenomas (ACRA) are precursors of colorectal cancer (CRC), and their removal is central for reducing incidence and mortality rates [1]. Treatment strategies for removal of ACRAs rely on their prior detection by colonoscopy and follow-up surveillance [2]. In the United States, patients with ACRAs are recommended to have 3year follow-up colonoscopies [3]. The removal of adenomas lowers the risk of CRC; CRC is still the third. Authors' Affiliations: 1Division of Gastroenterology and Hepatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease; and 2Division of Gastroenterology and Hepatology, Shanghai 1st Hospital, Shanghai Jiao Tong University, Shanghai, China. Note: Supplementary data for this article are available at Cancer Prevention Research Online (http://cancerprevres.aacrjournals.org/).

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