Hypermethylated DNA, a circulating biomarker for colorectal cancer detection

• Published in: PloS one Vol. 12; no. 7; p. e0180809
• Main Authors: Rasmussen, Simon Ladefoged, Krarup, Henrik Bygum, Sunesen, Kåre Gotschalck, Johansen, Martin Berg, Stender, Mogens Tornby, Pedersen, Inge Søkilde, Madsen, Poul Henning, Thorlacius-Ussing, Ole
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 10.07.2017; Public Library of Science (PLoS)
• Subjects: Age; Aged; Biochemistry; Biology and life sciences; Biomarkers; Biomarkers, Tumor - blood; Blood tests; Bone Morphogenetic Protein 3 - genetics; C-Reactive Protein - genetics; Cancer; Cancer screening; Case-Control Studies; Clinical medicine; Colon; Colonoscopy; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - blood; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - genetics; Committees; Cross-Sectional Studies; Deoxyribonucleic acid; Diagnosis; DNA; DNA methylation; DNA Methylation - genetics; DNA-Binding Proteins - genetics; Feces; Female; Gastrointestinal surgery; Gene Expression Regulation, Neoplastic - genetics; Genes; Genomes; Health aspects; Humans; Logistic Models; Male; Medical prognosis; Medical research; Medicine and Health Sciences; Methods; Methylation; Middle Aged; Nerve Tissue Proteins - genetics; Patients; Physical Sciences; Plasma; Polymerase chain reaction; Promoter Regions, Genetic - genetics; Receptors, Retinoic Acid - genetics; Research and Analysis Methods; Risk factors; ROC Curve; Screening; Sensitivity; Syndecan-2 - genetics; Thrombosis; Transcription Factors - genetics; Denmark
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0180809

Colorectal cancer (CRC) is one of the most common cancers in the western world. Screening is an efficient method of reducing cancer-related mortality. Molecular biomarkers for cancer in general and CRC in particular have been proposed, and hypermethylated DNA from stool or blood samples are already implemented as biomarkers for CRC screening. We aimed to evaluate the performance of proven hypermethylated DNA promoter regions as plasma based biomarkers for CRC detection. We conducted a cross-sectional case-control study of 193 CRC patients and 102 colonoscopy-verified healthy controls. Using methylation specific polymerase chain reaction, we evaluated 30 DNA promoter regions previously found to be CRC specific. We used multivariable logistic regression with stepwise backwards selection, and subsequent leave-pair-out cross validation, to calculate the optimism corrected area under the receiver operating characteristics curve (AUC) for all stage as well as early stage CRC. None of the individual DNA promoter regions provided an overall sensitivity above 30% at a reasonable specificity. However, seven hypermethylated promoter regions (ALX4, BMP3, NPTX2, RARB, SDC2, SEPT9, and VIM) along with the covariates sex and age yielded an optimism corrected AUC of 0.86 for all stage CRC and 0.85 for early stage CRC. Overall sensitivity for CRC detection was 90.7% at 72.5% specificity using a cut point value of 0.5. Individual hypermethylated DNA promoter regions have limited value as CRC screening markers. However, a panel of seven hypermethylated promoter regions show great promise as a model for CRC detection.