Quantitation of faecal Fusobacterium improves faecal immunochemical test in detecting advanced colorectal neoplasia.

Abstract:

OBJECTIVE:There is a need for an improved biomarker for colorectal cancer (CRC) and advanced adenoma. We evaluated faecal microbial markers for clinical use in detecting CRC and advanced adenoma. DESIGN:We measured relative abundance of Fusobacterium nucleatum (Fn), Peptostreptococcus anaerobius (Pa) and Parvimonas micra (Pm) by quantitative PCR in 309 subjects, including 104 patients with CRC, 103 patients with advanced adenoma and 102 controls. We evaluated the diagnostic performance of these biomarkers with respect to faecal immunochemical test (FIT), and validated the results in an independent cohort of 181 subjects. RESULTS:The abundance was higher for all three individual markers in patients with CRC than controls (p<0.001), and for marker Fn in patients with advanced adenoma than controls (p=0.022). The marker Fn, when combined with FIT, showed superior sensitivity (92.3% vs 73.1%, p<0.001) and area under the receiver-operating characteristic curve (AUC) (0.95 vs 0.86, p<0.001) than stand-alone FIT in detecting CRC in the same patient cohort. This combined test also increased the sensitivity (38.6% vs 15.5%, p<0.001) and AUC (0.65 vs 0.57, p=0.007) for detecting advanced adenoma. The performance gain for both CRC and advanced adenoma was confirmed in the validation cohort (p=0.0014 and p=0.031, respectively). CONCLUSIONS:This study identified marker Fn as a valuable marker to improve diagnostic performance of FIT, providing a complementary role to detect lesions missed by FIT alone. This simple approach may improve the clinical utility of the current FIT, and takes one step further towards a non-invasive, potentially more accurate and affordable diagnosis of advanced colorectal neoplasia.

journal_name

Gut

journal_title

Gut

authors

Wong SH,Kwong TNY,Chow TC,Luk AKC,Dai RZW,Nakatsu G,Lam TYT,Zhang L,Wu JCY,Chan FKL,Ng SSM,Wong MCS,Ng SC,Wu WKK,Yu J,Sung JJY

doi

10.1136/gutjnl-2016-312766

subject

Has Abstract

pub_date

2017-08-01 00:00:00

pages

1441-1448

issue

8

eissn

0017-5749

issn

1468-3288

pii

gutjnl-2016-312766

journal_volume

66

pub_type

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