Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jun 15, 2023; 15(6): 1086-1095
Published online Jun 15, 2023. doi: 10.4251/wjgo.v15.i6.1086
Diagnostic value of circular free DNA for colorectal cancer detection
Yao Cui, Lu-Jin Zhang, Jian Li, Yu-Jie Xu, Ming-Yue Liu
Yao Cui, Lu-Jin Zhang, Yu-Jie Xu, Ming-Yue Liu, Department of Oncology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou 450003, Henan Province, China
Jian Li, Department of General Surgery, Henan Tumor Hospital, The Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
Author contributions: Cui Y and Liu MY designed the study; Zhang LJ, Li J and Xu YJ performed the research; Cui Y and Li J analyzed the data; Cui Y wrote the manuscript; Cui Y and Liu MY revised the manuscript for final submission; Liu MY is the corresponding author.
Supported by the Henan Medical Science and Technology Research Program, No. LHGJ20210045.
Institutional review board statement: The study was reviewed and approved by the Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We declare that we have no financial or personal relationships with other individuals or organizations that can inappropriately influence our work and that there is no professional or other personal interest of any nature in any product, service and/or company that could be construed as influencing the position presented in or the review of the manuscript.
Data sharing statement: We have no data to share.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ming-Yue Liu, MD, Doctor, Department of Oncology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital, No. 7 Weiwu Road, Zhengzhou 450003, Henan Province, China. liumingyuezz@163.com
Received: March 13, 2023
Peer-review started: March 13, 2023
First decision: March 28, 2023
Revised: March 29, 2023
Accepted: May 17, 2023
Article in press: May 17, 2023
Published online: June 15, 2023
Abstract
BACKGROUND

Minimally invasive or noninvasive, sensitive and accurate detection of colorectal cancer (CRC) is urgently needed in clinical practice.

AIM

To identify a noninvasive, sensitive and accurate circular free DNA marker detected by digital polymerase chain reaction (dPCR) for the early diagnosis of clinical CRC.

METHODS

A total of 195 healthy control (HC) individuals and 101 CRC patients (38 in the early CRC group and 63 in the advanced CRC group) were enrolled to establish the diagnostic model. In addition, 100 HC individuals and 62 patients with CRC (30 early CRC and 32 advanced CRC groups) were included separately to validate the model. CAMK1D was dPCR. Binary logistic regression analysis was used to establish a diagnostic model including CAMK1D and CEA.

RESULTS

To differentiate between the 195 HCs and 101 CRC patients (38 early CRC and 63 advanced CRC patients), the common biomarkers CEA and CAMK1D were used alone or in combination to evaluate their diagnostic value. The area under the curves (AUCs) of CEA and CAMK1D were 0.773 (0.711, 0.834) and 0.935 (0.907, 0.964), respectively. When CEA and CAMK1D were analyzed together, the AUC was 0.964 (0.945, 0.982). In differentiating between the HC and early CRC groups, the AUC was 0.978 (0.960, 0.995), and the sensitivity and specificity were 88.90% and 90.80%, respectively. In differentiating between the HC and advanced CRC groups, the AUC was 0.956 (0.930, 0.981), and the sensitivity and specificity were 81.30% and 95.90%, respectively. After building the diagnostic model containing CEA and CAMK1D, the AUC of the CEA and CAMK1D joint model was 0.906 (0.858, 0.954) for the validation group. In differentiating between the HC and early CRC groups, the AUC was 0.909 (0.844, 0.973), and the sensitivity and specificity were 93.00% and 83.30%, respectively. In differentiating between the HC and advanced CRC groups, the AUC was 0.904 (0.849, 0.959), and the sensitivity and specificity were 93.00% and 75.00%, respectively.

CONCLUSION

We built a diagnostic model including CEA and CAMK1D for differentiating between HC individuals and CRC patients. Compared with the common biomarker CEA alone, the diagnostic model exhibited significant improvement.

Keywords: Healthy control, Colorectal cancer, Circular free DNA, Biomarker

Core Tip: Minimally invasive or noninvasive, sensitive and accurate detection of colorectal cancer (CRC) is urgently needed in clinical practice. We aimed to build a joint diagnostic model based on circular free DNA for detection of colorectal cancer. We evaluated the diagnostic value of circular free CAMK1D DNA for differentiating between HC individuals and CRC patients and demonstrated that CAMK1D may represent a potential diagnostic biomarker for CRC detection. Further analysis should use the colorectal polyp group to validate the diagnostic model in future studies.