title: Quantitation of faecalFusobacteriumimproves faecal immunochemical test in detecting advanced colorectal neoplasia.
abstract: There is a need for an improved biomarker for colorectal cancer (CRC) and advanced adenoma. We evaluated faecal microbial markers for clinical use in detecting CRC and advanced adenoma.
  
  
  
  We measured relative abundance ofFusobacterium nucleatum(Fn),Peptostreptococcus anaerobius(Pa) andParvimonas micra(Pm) by quantitative PCR in 309 subjects, including 104 patients with CRC, 103 patients with advanced adenoma and 102 controls. We evaluated the diagnostic performance of these biomarkers with respect to faecal immunochemical test (FIT), and validated the results in an independent cohort of 181 subjects.
  
  
  
  The abundance was higher for all three individual markers in patients with CRC than controls (p<0.001), and for markerFnin patients with advanced adenoma than controls (p=0.022). The markerFn, when combined with FIT, showed superior sensitivity (92.3% vs 73.1%, p<0.001) and area under the receiver-operating characteristic curve (AUC) (0.95 vs 0.86, p<0.001) than stand-alone FIT in detecting CRC in the same patient cohort. This combined test also increased the sensitivity (38.6% vs 15.5%, p<0.001) and AUC (0.65 vs 0.57, p=0.007) for detecting advanced adenoma. The performance gain for both CRC and advanced adenoma was confirmed in the validation cohort (p=0.0014 and p=0.031, respectively).
  
  
  
  This study identified markerFnas a valuable marker to improve diagnostic performance of FIT, providing a complementary role to detect lesions missed by FIT alone. This simple approach may improve the clinical utility of the current FIT, and takes one step further towards a non-invasive, potentially more accurate and affordable diagnosis of advanced colorectal neoplasia.
authors: State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong.|Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong.|CUHK Shenzhen Research Institute, Shenzhen, China.
authors: Sunny H
authors: 0000-0002-3354-9310
authors: SH
authors: Wong
authors: State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong.|Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors: Thomas N Y
authors: TNY
authors: Kwong
authors: State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong.|Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors: Tai-Cheong
authors: TC
authors: Chow
authors: State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong.|Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors: Arthur K C
authors: AKC
authors: Luk
authors: State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong.|Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors: Rudin Z W
authors: RZW
authors: Dai
authors: State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong.|Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors: Geicho
authors: G
authors: Nakatsu
authors: State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong.|Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors: Thomas Y T
authors: TYT
authors: Lam
authors: State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong.|Faculty of Medicine, Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors: Lin
authors: L
authors: Zhang
authors: State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong.|Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors: Justin C Y
authors: JCY
authors: Wu
authors: State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong.|Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors: Francis K L
authors: FKL
authors: Chan
authors: State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong.|Faculty of Medicine, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors: Simon S M
authors: SSM
authors: Ng
authors: State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong.|Faculty of Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors: Martin C S
authors: MCS
authors: Wong
authors: State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong.|Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors: Siew C
authors: SC
authors: Ng
authors: State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong.|Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong.|CUHK Shenzhen Research Institute, Shenzhen, China.|Faculty of Medicine, Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
authors: William K K
authors: WKK
authors: Wu
authors: State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong.|Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong.|CUHK Shenzhen Research Institute, Shenzhen, China.
authors: Jun
authors: J
authors: Yu
authors: State Key Laboratory of Digestive Disease, Department of Medicine and Therapeutics, Institute of Digestive Disease, Hong Kong, Hong Kong.|Faculty of Medicine, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong.|CUHK Shenzhen Research Institute, Shenzhen, China.
authors: Joseph J Y
authors: JJY
authors: Sung
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis*; D000236:Adenoma / Q000175:diagnosis*; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000032:analysis; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D004269:DNA, Bacterial / Q000032:analysis*; D005243:Feces / Q000382:microbiology*; D005260:Female; D016967:Fusobacterium nucleatum; D006801:Humans; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D010462:Peptostreptococcus; D012372:ROC Curve
chemical_list: D014408:Biomarkers, Tumor; D004269:DNA, Bacterial
keywords: COLONIC MICROFLORA; COLORECTAL ADENOMAS; COLORECTAL CANCER; COLORECTAL CANCER SCREENING