title: Improved stool DNA integrity method for early colorectal cancer diagnosis.
abstract: BACKGROUND
  DNA integrity analysis could represent an alternative approach to the early detection of colorectal cancer. Previously, fluorescence long DNA (FL-DNA) in stools was extracted using a manual approach and analyzed by capillary electrophoresis assay (CE FL-DNA). We aimed to improve diagnostic accuracy using a simpler and more standardized method [Real Time PCR FL-DNA (RT FL-DNA)] for the detection of early malignant lesions in a population undergoing colorectal cancer screening.
  
  
  METHODS
  From 241 stool samples, DNA was extracted using manual and semiautomatic extraction systems and analyzed using FL-DNA tests by CE and RT assays. The RT FL-DNA approach showed slightly higher sensitivity and specificity compared with the CE FL-DNA method. Furthermore, we compared the RT FL-DNA approach with the iFOBT report.
  
  
  RESULTS
  Nonparametric ranking statistics were used to analyze the relationship between the median values of RT FL-DNA and the clinicohistopathologic characteristics. The median values of both variables were significantly higher in patients with cancer than in patients with noncancerous lesions. According to the Fagan nomogram results, the iFOBT and FL-DNA methods provided more accurate diagnostic information and were able to identify subgroups at varying risks of cancer.
  
  
  CONCLUSIONS
  The combination of the semiautomatic extraction system and RT FL-DNA analysis improved the quality of DNA extracted from stool samples.
  
  
  CONCLUSIONS
  RT FL-DNA shows great potential for colorectal cancer diagnosis as it is a reliable and relatively easy analysis to perform on routinely processed stool samples in combination with iFOBT.
authors.affiliation: Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Rengucci
authors.affiliation: Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: De Maio
authors.affiliation: Diatech Pharmacogenetics, Jesi, Italy.
authors.forename: Maura
authors.initials: M
authors.lastname: Menghi
authors.affiliation: Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Scarpi
authors.affiliation: Gastroenterology Unit, University of Bologna, Imola Hospital, Imola, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Guglielmo
authors.affiliation: Gastroenterology Unit, University of Bologna, Imola Hospital, Imola, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Fusaroli
authors.affiliation: Gastroenterology Unit, University of Bologna, Imola Hospital, Imola, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Caletti
authors.affiliation: Pathology Unit, Morgagni-Pierantoni Hospital, Forlì, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Saragoni
authors.affiliation: Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Casadei Gardini
authors.affiliation: Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
authors.forename: Wainer
authors.initials: W
authors.lastname: Zoli
authors.affiliation: Epidemiology Unit and Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Falcini
authors.affiliation: Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy.
authors.forename: Dino
authors.initials: D
authors.lastname: Amadori
authors.affiliation: Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy. daniele.calistri@irst.emr.it.
authors.forename: Daniele
authors.initials: D
authors.lastname: Calistri
mesh_terms: D015179:Colorectal Neoplasms / Q000235:genetics*; D004247:DNA / Q000235:genetics*; D055088:Early Detection of Cancer; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening
chemical_list: D004247:DNA