Abstract
Early detection of colorectal cancer (CRC) is the most important factor in deciding its prognosis, so the need to develop an accurate screening test is a must. P-element induced wimpy testis (PIWI) RNA-823 (piR-823) is one of the first piRNAs recognized to be linked to malignancy. We aimed to investigate the expression levels of piR-823 in both serum and tissues of colorectal cancer patients and the ability to use its serum level as a non-invasive diagnostic biomarker to detect colorectal cancer. We determined piR-823 expression levels in 84 serum samples of CRC patients, 75 serum samples of healthy controls, and biological specimens obtained from the 84 patients with colorectal cancer from both the tumor tissues and the normal neighboring tissues using quantitative real-time reverse transcriptase-PCR. We showed that piR-823 had significantly higher serum and tissue expression levels in CRC patients compared to the controls. We observed a significant positive correlation between piR-823 serum levels and the staging of CRC, with significantly higher levels exhibiting advanced stages of CRC (III and IV). This translates into poorer differentiation and lymph node metastasis. The receiver operating characteristic curve (ROC curve) test showed 83.3% sensitivity and 89.3% specificity at a cut-off value of >5.98-fold change, with an area under the curve of 0.933 (p < 0.0001) concerning the ability of piR-823 in diagnosing patients with colorectal carcinoma. piR-823 expression is upregulated in colorectal cancer patients’ serum and tissues, and it can be used as a diagnostic noninvasive biomarker for CRC.
Highlights
We determined PIWI RNA-823 (piR-823) expression levels in the serum samples of 47 male and 37 female CRC patients of age 59.12 ± 2.61, 40 male and 35 female healthy controls of age 61.22 ± 3.31, and in biological tissues specimens obtained from the 84 patients with colorectal cancer including core tumor tissues and neighboring normal healthy tissues to detect the expression level of piR-823 and test the feasibility of using it as a tumor marker
When we investigate the association of piR-823 expression with the clinicopathological features of the CRC cases, we found that its expression in tissues showed no association with gender, tumor size, tumor location, and lymph node metastasis (p > 0.05); it associated with the staging of tumors and the differentiation degree, with a significantly elevated expression in poorly differentiated tumor tissues (3.9 ± 1.4) (p < 0.05) and stages
Correlation study of the relationship between expression of piR-823 in serum of colorectal carcinoma patients and the affected tissue shows a strong positive correlation, with a correlation coefficient of 0.9285, p < 0.0001 (Figure 2), proving that increased piR823 in tissues correlated with its increase in serum so there is no need to the invasive colonoscopy which can be replaced by noninvasive blood sampling. These results proved that piR-823 is upregulated in colorectal cancer, and its serum level can act as a diagnostic biomarker in CRC patients
Summary
One of the most common causes of death in patients with cancer is colorectal cancer (CRC) [1]. It is the third most diagnosed cancer in men and the second in women [1]. The prevalence of CRC is different all over the world, with a higher incidence in more developed countries (40%) [1]. New Zealand and Australia had reported the highest incidence rates (44.8% in the male and 32.2% in the female) but Western Africa was reported the lowest one (4.5% in the male and 3.8% in the female) [1]. The incidence rate of CRC in Egypt is
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