الفهرس 
COLORECTAL CARCINOMAOnly 14 pages are availabe for public view
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Abstract
ABSTRACT
Background: Colorectal cancer (CRC) is a significant global health concern, with increasing incidence rates associated with economic development and lifestyle changes. Conventional diagnostic methods for CRC suffer from limitations, prompting the exploration of novel biomarkers such as methylated Septin 9 (mSEPT9).
Aim of the Work: This case-control study aimed to determine the diagnostic efficacy of mSEPT9 for blood-based CRC detection in an Egyptian population. The study also sought to compare the diagnostic performance of mSEPT9 with two established tumor biomarkers, carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 (CA19-9).
Patients and Methods: Forty CRC patients from outpatient clinics at Ain Shams University Hospital and 40 matched healthy individuals were enrolled. Levels of mSEPT9, CEA, and CA19-9 were measured in both groups. Receiver operating characteristic (ROC) curve analysis was conducted to assess the discriminative power of these markers.
Results: Demographic data showed no significant differences between groups (p>0.05). Methylated Septin 9 levels were markedly higher in the CRC group (225.1 [164.2-344.8]) compared to controls (19.9 [12.1-43.2]) (p<0.001). Positive CEA results were more frequent in the CRC group (50%) compared to controls (96.7%) (p<0.001). Positive CA19-9 results were found in 20% of the CRC group and none in controls (p<0.05). ROC curve analysis demonstrated good discriminative power for mSEPT9 (accuracy = 88%, p<0.001) with a sensitivity of 89.2% and specificity of 86.7%. CEA showed moderate discriminative power (accuracy = 73.3%, p<0.05) with a sensitivity of 59% and specificity of 96.7%. CA19-9 exhibited poor discriminative power (accuracy = 60%, p<0.05) with a sensitivity of 20% and specificity of 100%. Combining all markers yielded an accuracy of 86.7% (p<0.001), sensitivity of 86.7%, and specificity of 86.7%.
Conclusion: Our results showed that plasma mSEPT9 represents a promising biomarker in CRC diagnosis. Therefore, further investigations on the diagnostic performance of the fecal test by different cut-off values are highly warranted. Along with the advantage of convenience and non-invasiveness, mSEPT9 is a promising biomarker in CRC detection. It could be expected that a further colonoscopy targeting the high-risk population (mSEPT9 positive) could improve the confirmation ability of CRC diagnosis, which avoids the repeated screening and reduces the invasive procedures. Combined use of mSEPT9 with traditional method could improve the diagnostic sensitivity especially among CRC patients in early stage, which may provide a new approach for future CRC screening, while further investigations with large sample size are highly warranted.