The Clinical Significance of Septin 9 and Colon Cancer Specific Antigen-2 (CCSA-2) in Colorectal Cancer

• Published in: Asian Pacific journal of cancer prevention : APJCP Vol. 24; no. 3; pp. 1027 - 1036
• Main Authors: Abd El Kader, Lamiaa, Soliman, Amira H, Salem, Salem E, Akel, Samia Y, Ibrahim, Noha H
• Format: Journal Article
• Language: English
• Published: Thailand West Asia Organization for Cancer Prevention 01.03.2023
• Subjects: Antigens, Neoplasm - genetics; Biomarkers, Tumor - genetics; Clinical Relevance; Colorectal Neoplasms - pathology; DNA Methylation; Early Detection of Cancer; Humans; Neoplasm Recurrence, Local - genetics; Septins - genetics; CCS Ag2; CRC; methyl septin 9
• ISSN: 1513-7368; 2476-762X
• DOI: 10.31557/APJCP.2023.24.3.1027

Colorectal cancer (CRC) is a major health problem Worldwide, Egypt shows a high rate of early CRC in the world as 35% of 1,600 Egyptian CRC patients were under 40 with threefold increased risk of death within 5 years. DNA methylation-based biomarkers as methylated Septin9 (mSEPT9) has a promising role for detecting CRC. As well as set of nuclear matrix proteins associated with changes in the nuclear structure/architecture. detection of these nuclear proteins resulted in identification of biomarkers that are specific for colon cancer. Particular interest has been placed on colon cancer specific antigen-2(CCSA-2). A total of 30 newly diagnosed CRC patients, 7 colonic adenoma patients, and 15 age- and sex-matched control subjects were recruited in this study. Plasma mSEPT9was assayed by Epi procolon kit, CCSA-2 by ELISA and, Occult blood in stool by Guaiac-based fecal occult blood test. The level of Colon Cancer mSEPT9 and CCSA-2 were carried on CRC patients both preoperatively and three months postoperatively. mSEPT9 has 96.7% sensitivity and 95.5% specificity in differentiating colorectal cancer patients from non-malignant cases. Also, our study showed a highly statistically significant difference between the pre and three months postoperative expression of mSEPT9 in colorectal cancer as there was a dramatically decrease in the expression of mSEPT9 postoperatively (p value < 0.001). The CCSA-2 at the cutoff level of >1.43 would provide 93.3% sensitivity and 90.9% specificity in differentiation between malignant and non-malignant cases. Also, the study showed that there is a statistically significant difference between colorectal cancer patients preoperatively and postoperatively according to CCSA-2 with dramatic decrease in its level postoperatively (p value > 0.001). The plasma SEPT9 DNA methylation level and Serum CCSA-2 could be used as promising non-invasive methods for observing the CRC patients postsurgical response to predict the occurrence of complete remission or relapses.