Abstract
Colorectal cancer screening programs aim at early detection of cancer to reduce incidence rates and mortality. The objective of this study is to identify the role of neurotensin in the endoscopic screening of high-risk population for developing colorectal neoplasia. Blood samples from patients referred for urgent colonoscopy to investigate symptoms suspicious of colorectal cancer were collected. Blood neurotensin levels were measured using enzyme-linked immunosorbent assay. Colonoscopy findings were used as reference for determining the diagnostic accuracy of blood neurotensin. The study comprised 26 patients in total: 12 healthy and 14 with colon pathology (13 high-grade dysplasia adenomatous polyps, 1 adenocarcinoma). There were no statistically significant differences in the clinical and biochemical parameters between colon pathology and healthy group except neurotensin levels. Pathology in colon was associated with 3.7-fold increase in NT levels. In multivariate analysis, patients with pathology in colon have increased serum neurotensin levels compared to controls adjusted for age, gender, BMI and co-morbidities. The value of 12.93 pg/ml is associated with 87.5% sensitivity and 91.7% specificity for discriminating the colon pathology from normal colonic epithelium (p = 0.001). Neurotensin plasma values differentiate healthy people from patients suffering from colonic pathologies such as adenomatous polyps and cancer. The use of neurotensin as a potential endoscopic screening tool for identifying high-risk population for developing colorectal cancer is promising, but much has to be done before it is validated in larger scale prospective studies.
Highlights
Colorectal cancer (CRC) is a worldwide health problem that ranks third in incidence and fourth in mortality with an estimated 1.2 million cases and 0.6 million deaths annually [1, 2]
The objective of this study is to identify the role of neurotensin in the endoscopic screening of high-risk population for developing colorectal neoplasia
Patients with pathology in colon have increased serum neurotensin levels compared to controls adjusted for age, gender, BMI and co-morbidities
Summary
Colorectal cancer (CRC) is a worldwide health problem that ranks third in incidence and fourth in mortality with an estimated 1.2 million cases and 0.6 million deaths annually [1, 2]. Mortality can be lowered by both early diagnosis and cancer prevention where the objective of screening is to detect cancer at an early curable stage. The European Union (EU) recommendations for CRC screening is based on tests with quality assurance for the diagnosis and management of patients with screen-detected lesions. In countries with a serious burden of CRC, screening promotes cancer control, provided the services are of high quality. Studies have shown that patients over the age of 60 having had a normal colonoscopy can be followed with FOBT or computerized tomography (CT) pneumocolon every 5 years. This screening process can provide overall the same survival benefit with less morbidity and cost [3]. Colonoscopic surveillance is considered the gold standard in detecting colonic malignancy compared to FOBT; low participation rate has questioned its benefit [4]
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