Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 7, 2019; 25(17): 2099-2109
Published online May 7, 2019. doi: 10.3748/wjg.v25.i17.2099
Clinical value of preoperative methylated septin 9 in Chinese colorectal cancer patients
Xue Yang, Zhi-Jie Xu, Xi Chen, Shuang-Shuang Zeng, Long Qian, Jie Wei, Mei Peng, Xiang Wang, Wan-Li Liu, Hong-Ying Ma, Zhi-Cheng Gong, Yuan-Liang Yan
Xue Yang, Xi Chen, Shuang-Shuang Zeng, Long Qian, Jie Wei, Mei Peng, Xiang Wang, Wan-Li Liu, Hong-Ying Ma, Zhi-Cheng Gong, Yuan-Liang Yan, Department of Pharmacy, Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China
Zhi-Jie Xu, Department of Pathology, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China
Author contributions: Yang X and Xu ZJ designed the research scheme and contributed equally to this article; Yan YL and Gong ZC contributed equally to correspondence about this manuscript; Chen X, Zeng SS, Qian L, and Wei J collected data from the samples; Peng M, Wang X, Liu WL, Xu ZJ, and Ma HY analyzed the data.
Supported by the National Natural Science Foundation of China, No. 81803035, No. 81703036, and No. 81572946; the China Postdoctoral Science Foundation, No. 2017M610510; and the Youth Fund of Xiangya Hospital, No. 2017Q17.
Institutional review board statement: This study was reviewed and approved by the Ethical Committee of Xiangya Hospital of Central South University (Approval No. 2018111100).
Informed consent statement: According to the “Human Biomedical Research Ethical Review Procedures” approved by the National Health and Family Planning Committee of China (No. 11, Section 39), informed consent was waived because of the retrospective nature of the study. After the following circumstances have been reviewed and approved by the ethics committee, the informed consent form can be waived if: Research is conducted using human body materials or data that can identify information, and the subjects can’t be found, and the research project does not involve personal privacy and commercial interests.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Zhi-Cheng Gong, PhD, Professor, Department of Pharmacy, Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha 410008, Hunan Province, China. gongzhicheng@csu.edu.cn
Telephone: +86-731-84327306
Received: February 14, 2019
Peer-review started: February 15, 2019
First decision: March 5, 2019
Revised: March 25, 2019
Accepted: April 10, 2019
Article in press: April 10, 2019
Published online: May 7, 2019
ARTICLE HIGHLIGHTS
Research background

The methylated septin 9 (mSEPT9) assay was the first blood-based test approved by the United States Food and Drug Administration as a colorectal screening test. Previous researchers found that mSEPT9 was a powerful screening, diagnostic, monitoring, and prognostic tool for German colorectal cancer (CRC) patients. However, the diagnostic and prognostic value of mSEPT9 in Chinese CRC patients is still unknown, and may be affected by differences in ethnicity and socioeconomic status.

Research motivation

To explore the diagnostic and prognostic value of serum mSEPT9 for Chinese CRC patients.

Research objectives

This study aimed to explore the diagnostic value of preoperative serum mSEPT9 in the Chinese population, and then assess the value of quantitative mSEPT9 levels for CRC staging. In addition, Chinese population and TCGA database information were combined to determine the prognostic significance of mSEPT9 by bioinformatics analyses.

Research methods

Three hundred fifty-four subjects (300 CRC, 54 normal) from China and 351 subjects (330 CRC, 21 normal) from the TCGA database including American Indian, Asian, Black, and African American populations were retrospectively analyzed. Preoperative mSEPT9 levels were quantified by quantitative methylation-specific polymerase chain reaction. Kaplan-Meier univariate assay was performed to analyze potential prognostic factors including overall survival (OS) and progression-free survival (PFS).

Research results

In Chinese CRC patients, positive mSEPT9 and quantitative mSEPT9 levels were strongly associated with clinico-pathological parameters. The patients with positive mSEPT9 showed a tendency toward lower PFS. Higher mSEPT9 levels were correlated with more distant metastasis among the TCGA database patients, and patients with high mSEPT9 levels showed a tendency toward lower OS.

Research conclusions

Testing for mSEPT9 is a powerful diagnostic and promising prognostic tool for Chinese CRC patients; it may add valuable information to current tumor staging and holds the potential to monitor CRC recurrence.

Research perspectives

This study assessed the correlation between clinicopathological characteristics and preoperative serum mSEPT9 in Chinese CRC patients and, further, to confirm the correlation between mSEPT9 levels and CRC prognosis by bioinformatics analyses. In addition, we analyzed methylated sites that were co-upregulated or co-downregulated in colon and rectum tumors, to provide the theoretical guidance for further research.