title: Fecal cyclooxygenase 2 plus matrix metalloproteinase 7 mRNA assays as a marker for colorectal cancer screening.
abstract: We previously reported that fecal cyclooxygenase 2 (COX-2) mRNA assay, detecting COX-2 mRNA in feces, is useful for identifying subjects with colorectal cancer (CRC). To further improve the sensitivity, we evaluated the usefulness of the combination of COX-2 mRNA and matrix metalloproteinase 7 (MMP-7) mRNA assays as a marker of CRC. The study cohort included 62 patients with CRC and 29 control patients without colorectal neoplasia. RNA was isolated from routinely collected fecal samples. The expression levels of COX-2 and MMP-7 mRNAs were determined by nested reverse transcription-PCR. PCR conditions were optimized where the specificity of fecal COX-2 and MMP-7 mRNA assay result in 100%. The sensitivity of each fecal assay was 87% [95% confidence interval (95% CI), 76-94%] and 65% (95% CI, 51-76%) for CRC, respectively. The sensitivity of fecal RNA test (either marker being positive) was high for CRC (90%; 95% CI, 80-96%). The sensitivity of the fecal RNA test was also high (93%; 95% CI, 80-98%) in patients with stage I or II who are often cured by surgical resection. The fecal RNA test using COX-2 and MMP-7 mRNAs improved the sensitivity to detect CRC without decreasing the specificity. These results suggest that the fecal RNA test would be a promising approach for CRC screening, although larger clinical investigations are indicated.
authors.affiliation: First Department of Medicine, Hamamatsu University School of Medicine, Enshu Hospital, Hamamatsu, Japan. kanaoka@hama-med.ac.jp
authors.forename: Tetsunari
authors.initials: T
authors.lastname: Takai
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kanaoka
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Yoshida
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Hamaya
authors.forename: Mutsuhiro
authors.initials: M
authors.lastname: Ikuma
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Miura
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Sugimura
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kajimura
authors.forename: Akira
authors.initials: A
authors.lastname: Hishida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D002272:Carcinoembryonic Antigen / Q000032:analysis / Q000235:genetics; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000201:enzymology / Q000235:genetics; D051546:Cyclooxygenase 2 / Q000032:analysis* / Q000235:genetics; D055088:Early Detection of Cancer; D005243:Feces / Q000737:chemistry / Q000201:enzymology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008403:Mass Screening / Q000379:methods*; D020783:Matrix Metalloproteinase 7 / Q000032:analysis* / Q000235:genetics; D008875:Middle Aged; D009367:Neoplasm Staging; D009780:Occult Blood; D012333:RNA, Messenger / Q000032:analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D012333:RNA, Messenger; D051546:Cyclooxygenase 2; D020783:Matrix Metalloproteinase 7