title: Investigation of cell free BIRC5 mRNA as a serum diagnostic and prognostic biomarker for colorectal cancer.
abstract: BACKGROUND
  BIRC5 (Survivin), a key member of inhibitor of apoptosis family, has been shown in colorectal cancer (CRC) tumorigenesis and progress. This study investigated the expression levels of cell free BIRC5 mRNA in serum of CRC and assess its diagnostic and prognostic potential.
  
  
  METHODS
  Levels of cell free BIRC5 mRNA were detected by reverse transcription quantitative real-time PCR in serum of 92 CRC patients and 60 healthy volunteers.
  
  
  RESULTS
  Cell free BIRC5 mRNA levels were significantly increased in serum of CRC (P < 0.001), and significantly correlated with tumor differentiation (P = 0.035), regional lymph node metastasis (P < 0.001) and TNM stage (P < 0.001). ROC curve demonstrated an optimal cut-off value of 0.128, providing a sensitivity of 84.8% and a specificity of 80.0% for discriminating CRC from controls. The area under the ROC curve for BIRC5 mRNA was significantly larger than that for CEA (0.855 vs. 0.691, P < 0.001). Furthermore, a significantly higher diagnosis capability was showed when combined BIRC5 mRNA and CEA. High serum BIRC5 mRNA expression has a lower OS, compared with low group (36.4% vs. 73.3%, P = 0.022), and was an independent prognostic factor for CRC.
  
  
  CONCLUSIONS
  Serum cell free BIRC5 mRNA is a promising non-invasive biomarker for diagnosis and prognosis of CRC.
authors: Department of Clinical Laboratory, Qilu Hospital, Shandong University, Jinan, China.
authors: Haiyan
authors: H
authors: Wang
authors: Xin
authors: X
authors: Zhang
authors: Lili
authors: L
authors: Wang
authors: Guixi
authors: G
authors: Zheng
authors: Lutao
authors: L
authors: Du
authors: Yongmei
authors: Y
authors: Yang
authors: Zhaogang
authors: Z
authors: Dong
authors: Yimin
authors: Y
authors: Liu
authors: Ailin
authors: A
authors: Qu
authors: Chuanxin
authors: C
authors: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000401:mortality*; D005260:Female; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins / Q000097:blood / Q000235:genetics*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012333:RNA, Messenger / Q000097:blood*; D012372:ROC Curve; D060888:Real-Time Polymerase Chain Reaction; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D000077022:Survivin
chemical_list: C107489:BIRC5 protein, human; D015415:Biomarkers; D002272:Carcinoembryonic Antigen; D051034:Inhibitor of Apoptosis Proteins; D012333:RNA, Messenger; D000077022:Survivin
keywords: cell free BIRC5 mRNA; colorectal cancer; diagnosis; prognosis