TY - JOUR
T1 - Assessment of novel combinations of biomarkers for the detection of colorectal cancer.
AU - Shimwell, Neil
AU - Wei, Wenbin
AU - Wilson, Sue
AU - Wakelam, Michael
AU - Ismail, Tariq
AU - Iqbal, Tariq
AU - Johnson, Philip
AU - Martin, Ashley
AU - Ward, Douglas
PY - 2010/1/1
Y1 - 2010/1/1
N2 - BACKGROUND
Patients with colorectal cancer often present with advanced disease and concomitant poor prognosis. The best known serum biomarker, carcinoembryonic antigen (CEA) is not recommended for screening because of its limited specificity and sensitivity. A number of other circulating proteins have been suggested to be diagnostically useful but individually none of these has proved to be of sufficient sensitivity or specificity to establish a role in routine clinical practice. Here, we test the hypothesis that combining several of these biomarkers will improve diagnostic efficacy.
METHODS
To select the markers for our model we screened CEA and 26 other candidate biomarkers. Four candidates were selected and their concentrations determined in the serum of 239 patients (106 colorectal cancer patients and 133 non-cancer subjects).
RESULTS
Class prediction models based on CEA, DR-70 and sCD26 produced a modest increase in detection accuracy over CEA alone, particularly for early stage cancers. The sensitivity and specificity required for a clinically useful test was not reached.
CONCLUSION
It is unlikely that a biomarker panel comprised of the currently available serum markers will generate a clinically useful diagnostic test for colorectal cancer. Our findings reiterate the urgent need to discover novel biomarkers for the detection of colorectal cancer.
AB - BACKGROUND
Patients with colorectal cancer often present with advanced disease and concomitant poor prognosis. The best known serum biomarker, carcinoembryonic antigen (CEA) is not recommended for screening because of its limited specificity and sensitivity. A number of other circulating proteins have been suggested to be diagnostically useful but individually none of these has proved to be of sufficient sensitivity or specificity to establish a role in routine clinical practice. Here, we test the hypothesis that combining several of these biomarkers will improve diagnostic efficacy.
METHODS
To select the markers for our model we screened CEA and 26 other candidate biomarkers. Four candidates were selected and their concentrations determined in the serum of 239 patients (106 colorectal cancer patients and 133 non-cancer subjects).
RESULTS
Class prediction models based on CEA, DR-70 and sCD26 produced a modest increase in detection accuracy over CEA alone, particularly for early stage cancers. The sensitivity and specificity required for a clinically useful test was not reached.
CONCLUSION
It is unlikely that a biomarker panel comprised of the currently available serum markers will generate a clinically useful diagnostic test for colorectal cancer. Our findings reiterate the urgent need to discover novel biomarkers for the detection of colorectal cancer.
U2 - 10.3233/CBM-2010-0155
DO - 10.3233/CBM-2010-0155
M3 - Article
C2 - 21263188
SN - 1875-8592
VL - 7
SP - 123
EP - 132
JO - Cancer biomarkers : section A of Disease markers
JF - Cancer biomarkers : section A of Disease markers
IS - 3
ER -
