Improved stool DNA integrity method for early colorectal cancer diagnosis.
Cancer Epidemiol Biomarkers Prev. 2014-08-15; 23(11): 2553-2560
DOI: 10.1158/1055-9965.epi-14-0379
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1. Cancer Epidemiol Biomarkers Prev. 2014 Nov;23(11):2553-60. doi:
10.1158/1055-9965.EPI-14-0379. Epub 2014 Aug 15.
Improved stool DNA integrity method for early colorectal cancer diagnosis.
Rengucci C(1), De Maio G(1), Menghi M(2), Scarpi E(3), Guglielmo S(4), Fusaroli
P(4), Caletti G(4), Saragoni L(5), Casadei Gardini A(6), Zoli W(1), Falcini F(7),
Amadori D(6), Calistri D(8).
Author information:
(1)Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura
dei Tumori (IRST) IRCCS, Meldola, Italy.
(2)Diatech Pharmacogenetics, Jesi, Italy.
(3)Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per
lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
(4)Gastroenterology Unit, University of Bologna, Imola Hospital, Imola, Italy.
(5)Pathology Unit, Morgagni-Pierantoni Hospital, Forlì, Italy.
(6)Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e
la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
(7)Epidemiology Unit and Romagna Cancer Registry, Istituto Scientifico Romagnolo
per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
(8)Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura
dei Tumori (IRST) IRCCS, Meldola, Italy. .
BACKGROUND: DNA integrity analysis could represent an alternative approach to the
early detection of colorectal cancer. Previously, fluorescence long DNA (FL-DNA)
in stools was extracted using a manual approach and analyzed by capillary
electrophoresis assay (CE FL-DNA). We aimed to improve diagnostic accuracy using
a simpler and more standardized method [Real Time PCR FL-DNA (RT FL-DNA)] for the
detection of early malignant lesions in a population undergoing colorectal cancer
screening.
METHODS: From 241 stool samples, DNA was extracted using manual and semiautomatic
extraction systems and analyzed using FL-DNA tests by CE and RT assays. The RT
FL-DNA approach showed slightly higher sensitivity and specificity compared with
the CE FL-DNA method. Furthermore, we compared the RT FL-DNA approach with the
iFOBT report.
RESULTS: Nonparametric ranking statistics were used to analyze the relationship
between the median values of RT FL-DNA and the clinicohistopathologic
characteristics. The median values of both variables were significantly higher in
patients with cancer than in patients with noncancerous lesions. According to the
Fagan nomogram results, the iFOBT and FL-DNA methods provided more accurate
diagnostic information and were able to identify subgroups at varying risks of
cancer.
CONCLUSIONS: The combination of the semiautomatic extraction system and RT FL-DNA
analysis improved the quality of DNA extracted from stool samples.
IMPACT: RT FL-DNA shows great potential for colorectal cancer diagnosis as it is
a reliable and relatively easy analysis to perform on routinely processed stool
samples in combination with iFOBT.
©2014 American Association for Cancer Research.
DOI: 10.1158/1055-9965.EPI-14-0379
PMID: 25128402 [Indexed for MEDLINE]