title: Transcriptomic molecular markers for screening human colon cancer in stool and tissue.
abstract: There is a need for sensitive and specific diagnostic molecular markers that can be used to monitor early patterns of gene expression in non-invasive exfoliated colonocytes shed in the stool, and in situ in adenoma-carcinoma epithelium of the colon. RNA-based detection methods are more comprehensive than either DNA-, protein- or methylation-based screening methods. By routinely and systematically being able to perform quantitative gene expression studies on these samples using less than ten colon cancer genes selected by the enormous resources of the National Cancer Institute's Cancer Genome Anatomy Project, we were able to monitor changes at various stages in the neoplastic process, allowing for reliable diagnostic screening of colon cancer particularly at the early, pre-malignant stages. Although the expression of some of the genes tested in tissue showed less variability in normal or cancerous patients than in stool, the stool by itself is suitable for screening. Thus, a transcriptomic approach using stool or tissue samples promises to offer more sensitivity and specificity than currently used molecular screening methods for colon cancer. A larger prospective clinical study utilizing stool and tissue samples derived from many control and colon cancer patients, to allow for a statistically valid analysis, is now urgently required to determine the true sensitivity and specificity of the transcriptomic screening approach for this preventable cancer.
authors.affiliation: Department of Radiation Oncology, LSB 003, Leo W. Jenkins Cancer Center at East Carolina University (ECU), Greenville, NC 27858; USA. ahmedf@ecu.edu
authors.forename: Farid E
authors.initials: FE
authors.lastname: Ahmed
authors.forename: Paul
authors.initials: P
authors.lastname: Vos
authors.forename: Stephanie
authors.initials: S
authors.lastname: iJames
authors.forename: Donald T
authors.initials: DT
authors.lastname: Lysle
authors.forename: Ron R
authors.initials: RR
authors.lastname: Allison
authors.forename: Gordon
authors.initials: G
authors.lastname: Flake
authors.forename: Dennis R
authors.initials: DR
authors.lastname: Sinar
authors.forename: Wade
authors.initials: W
authors.lastname: Naziri
authors.forename: Stefan P
authors.initials: SP
authors.lastname: Marcuard
authors.forename: Rodney
authors.initials: R
authors.lastname: Pennington
mesh_terms: D014408:Biomarkers, Tumor / Q000235:genetics*; D003106:Colon / Q000378:metabolism / Q000473:pathology*; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000235:genetics* / Q000473:pathology; D005243:Feces / Q000737:chemistry*; D005260:Female; D005453:Fluorescence; D015972:Gene Expression Regulation, Neoplastic; D019073:HT29 Cells; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening; D011230:Precancerous Conditions / Q000473:pathology; D020871:RNA Stability; D012334:RNA, Neoplasm / Q000235:genetics / Q000378:metabolism; D014158:Transcription, Genetic; D014481:United States
chemical_list: D014408:Biomarkers, Tumor; D012334:RNA, Neoplasm