Potential usefulness of detecting cyclooxygenase 2 messenger RNA in feces for colorectal cancer screening
Potential usefulness of detecting cyclooxygenase 2 messenger RNA in feces for colorectal cancer screening
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DOI：
10.1053/j.gastro.2004.05.022
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发表时间：
2004-08-01
期刊：
影响因子：
29.4
通讯作者：
Kajimura, M
中科院分区：
文献类型：
--
作者：
Kanaoka, S;Yoshida, KI;Kajimura, M
背景与目的：环加氧酶 2 (COX-2) 在呼吸消化肿瘤中频繁过度表达，尤其是在结直肠肿瘤中。因此，它可能是结直肠癌（CRC）筛查的合适生物标志物。我们进行了一项初步研究，检测粪便 RNA 中 COX-2 的表达是否能让我们区分患有和不患有 CRC 的患者。方法：研究队列包括 29 名 CRC 患者和 22 名没有结肠或直肠肿瘤性疾病的对照患者。使用改良方法从常规收集的粪便样本中分离出 RNA。采用巢式逆转录聚合酶链反应（RT-PCR）测定癌胚抗原（CEA）和COX-2的表达水平。结果：粪便 COX-2 检测对 CRC 的敏感性和特异性分别为 90%（95% CI，73%-98%）和 100%（95% CI，85%-100%），而粪便 CEA 检测对 CRC 的敏感性和特异性分别为 100%（95% CI，88%-100%）和 5%（95% CI，85%-100%）。 2%-23%），分别。在 4 名 Dukes A 期患者中的 3 名、14 名 Dukes 13 期患者中的 13 名以及 11 名 Dukes C 或 D 期患者中的 10 名中检测到了 COX-2 信使 RNA (mRNA)。在 7 名近端癌症患者中的 5 名和 22 名远端癌症患者中的 21 名中检测到了 COX-2 mRNA。 COX-2 检测在检测 CRC 方面优于 CEA 检测，尽管这两种检测都具有高灵敏度。结论：粪便COX-2检测对于CRC检测具有高灵敏度和高特异性。这些结果表明，这将是检测 CRC 的一种有前途的方法，尽管需要进行更大规模的研究来评估敏感性和特异性。
Background & Aims: Cyclooxygenase 2 (COX-2) is overexpressed frequently in aerodigestive tumors, especially in colorectal tumors. Therefore, it may be a suitable biomarker for colorectal cancer (CRC) screening. We performed a pilot study of whether detecting COX-2 expression in fecal RNA enables us to discriminate between patients with and without CRC. Methods: The study cohort included 29 patients with CRC, and 22 control patients without neoplastic disease of the colon or rectum. RNA was isolated from routinely collected stool samples using a modified method. The expression levels of carcinoembryonic antigen (CEA) and COX-2 were determined by nested reverse-transcription polymerase chain reaction (RT-PCR). Results: The sensitivity and the specificity of fecal COX-2 assay for CRC were 90% (95% confidence interval [CI], 73%-98%) and 100% (95% CI, 85%-100%), respectively, whereas those of the fecal CEA assay for CRC were 100% (95% CI, 88%-100%) and 5% (95% CI, 2%-23%), respectively. COX-2 messenger RNA (mRNA) was detected in 3 of 4 patients with Dukes' stage A, 13 of 14 patients with Dukes' stage 13, and 10 of 11 patients with Dukes' stage C or D. COX-2 mRNA was detected in 5 of 7 patients with proximal cancer and in 21 of 22 patients with distal cancer. The COX-2 assay was superior to the CEA assay for detecting CRC in terms of specificity, although both assays had high sensitivity. Conclusions: This fecal COX-2 assay had high sensitivity and high specificity for detecting CRC. These results suggest that it would be a promising approach for detecting CRC, although a larger study is necessary to assess the sensitivity and the specificity.