title: The Relationship between the Methylated Septin-9 DNA Blood Test and Stool Occult Blood Test for Diagnosing Colorectal Cancer in Taiwanese People.
abstract: BACKGROUND
  Colorectal cancer (CRC) is a common and lethal disease in the world. There is an increasing number of cases in Taiwan and a higher rate at advanced stages. The immune fecal occult blood test (iFOBT) has been used as a screening method in Taiwan for years. A new novel diagnostic tool, the Methylated Septin-9 (MS-9) DNA blood test, had been reported to have high sensitivity and specificity for CRC detection. There are no available data in Taiwan, so we conducted this prospective randomized trial to investigate the relationship among the MS-9 DNA blood test, iFOBT, and a combination of the two tests for diagnosing CRC in Taiwanese people.
  
  
  METHODS
  From July 1, 2012 to December 31, 2013, we prospectively selected 60 plasma samples from patients who were diagnosed with CRC and otherwise, the healthy group by colonoscopy in our hospital. Patients were divided into the CRC group and healthy group. CRC stages 0, I, II and stages III and IV were separately analyzed. We calculated the sensitivity and specificity of each group to determine the relationship among the MS-9 DNA blood test, iFOBT, and a combination of the two tests for diagnosing CRC in Taiwanese people.
  
  
  RESULTS
  The results of the MS-9 DNA blood test for the 60 samples were divided into three groups, and the sensitivity as well as the specificity of the MS-9 DNA blood test to detect CRC were 47% and 89%, respectively. The results of iFOBT were also divided into three groups, and had higher sensitivity (84%) but lower specificity (55%) using iFOBT to detect CRC. Higher rates could be predicted to detect CRC if both the tests were positive.
  
  
  CONCLUSIONS
  A combined MS-9 DNA blood test and iFOBT may help in a higher detection rate of CRC. It could be offered to individuals who are unwilling or unable to undergo colonoscopy. Further large prospective, randomized studies are needed in the future.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan.
authors.forename: Chung-Hung
authors.initials: CH
authors.lastname: Chen
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan.
authors.forename: Sheng-Lei
authors.initials: SL
authors.lastname: Yan
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan.
authors.forename: Tsung-Hsun
authors.initials: TH
authors.lastname: Yang
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan.
authors.forename: Shih-Feng
authors.initials: SF
authors.lastname: Chen
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan.
authors.forename: Yung-Hsiang
authors.initials: YH
authors.lastname: Yeh
authors.affiliation: Division of General Surgery, Department of Surgery, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan.
authors.forename: Jing-Jim
authors.initials: JJ
authors.lastname: Ou
authors.affiliation: Division of General Surgery, Department of Surgery, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan.
authors.forename: Chien-Hua
authors.initials: CH
authors.lastname: Lin
authors.affiliation: Division of General Surgery, Department of Surgery, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan.
authors.forename: Yueh-Tsung
authors.initials: YT
authors.lastname: Lee
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Chang Hua Show Chwan Memorial Hospital, Changhua, Taiwan.
authors.forename: Chien-Hua
authors.initials: CH
authors.lastname: Chen
mesh_terms: D000368:Aged; D019540:Area Under Curve; D015179:Colorectal Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000235:genetics; D019175:DNA Methylation / Q000235:genetics*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D058112:Septins / Q000097:blood*; D013624:Taiwan
chemical_list: C474315:SEPTIN9 protein, human; D058112:Septins
keywords: colorectal cancer; immune fecal occult blood test; methylated Septin-9 DNA blood test