Abstract
Identification of effective biomarkers is crucial for monitoring the treatment and remission of colorectal cancer (CRC) and improving survival. It is particularly important to diagnose CRC before the tumor metastasizes (stage I–II disease) where possible, to provide the greatest opportunity for patient recovery. Here, we evaluated the clinical value of serum chemokine (C-X-C) ligand 7 (CXCL7) concentration as a biomarker for CRC diagnosis. An enzyme-linked immunosorbent assay was used to measure CXCL7 concentration in 560 serum samples from patients with CRC and controls. Logistic regression and receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic efficacy and build mathematical diagnostic models. The concentration of CXCL7 in the CRC group was significantly higher than that in the control group (P < 0.001), with an area under the ROC curve (AUC) value of 0.862 [95% confidence interval (CI): 0.831–0.890]. Further, the AUC of a regression model including the markers carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and carbohydrate antigen 125 (CA125), along with CXCL7, was 0.933 (95% CI: 0.909–0.952). For stage I–II tumors, CXCL7 had the highest AUC (0.823, 95% CI: 0.783–0.858) among the four individual biomarkers. The AUC value for combination model analysis of samples from patients with stage I–II tumors was 0.904 (95% CI: 0.872–0.930), with a sensitivity of 82.76% and a specificity of 87.14%, and an optimal cut-off value of 2.66. AUC values for application of the regression model in subgroup analysis were 0.947 (0.917–0.968) and 0.919 (0.874–0.951) for males and females, respectively. These results suggest that CXCL7 has potential as a serum diagnostic biomarker for detection of CRC. Importantly, the combination of CXCL7, CEA, CA125, and CA19-9 may facilitate diagnosis of CRC with relatively high sensitivity and specificity.Clinical Trial Registration Number: LS2017001.
Highlights
Colorectal cancer (CRC) is a common malignant tumor with high levels of mortality [1]; it is the third most common cancer and the fourth leading cause of cancer-related deaths worldwide [2]
With recent economic development, environmental pollution, sedentary lifestyles, and increased fast food consumption, the age of morbidity is gradually reducing [19]; early diagnosis and treatment are vital for improving the overall survival rate of patients with colorectal cancer (CRC)
Peripheral blood, a substitute for tissue biopsy, is convenient to collect and easy to analyze for biomarker detection [20]
Summary
Colorectal cancer (CRC) is a common malignant tumor with high levels of mortality [1]; it is the third most common cancer and the fourth leading cause of cancer-related deaths worldwide [2]. Colonoscopy and tissue biopsy are the most effective methods of CRC diagnosis; colonoscopy is an invasive procedure that can cause trauma to patients, and the entire surgical process can sometimes be difficult to complete owing to poor compliance among patients with CRC [7]. More non-invasive, sensitive, and effective biomarkers are urgently needed for clinical application. Carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA19-9), and carbohydrate antigen 125 (CA125) are widely used in tumor detection [10]; these three biomarkers, alone or in combination, are inadequate for CRC diagnosis, owing to their low sensitivity and specificity [11]. It is imperative to identify additional effective serum biomarkers to facilitate optimization of the diagnosis and treatment of CRC, at non-metastatic stages (stages I–II)
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