J Cancer 2021; 12(9):2665-2672. doi:10.7150/jca.52478 This issue Cite

Research Paper

Methylated SFRP2 and SDC2 in stool specimens for Colorectal Cancer early detection: A cost-effective strategy for Chinese population

Guodong Zhao1,2,5, Xiaoyu Liu2, Yi Liu4,6, Yong Ma2,3, Jun Yang4,6, Hui Li4,6, Shangmin Xiong2,5, Sujuan Fei4,6✉, Minxue Zheng2,3✉, Xiangwei Zhao1✉

1. State Key Laboratory of Bioelectronics, School of Biological Science and Medical Engineering, Southeast University, Nanjing 210009, China.
2. Zhejiang University Kunshan Biotechnology Laboratory, Zhejiang University Kunshan Innovation Institute, Kunshan Jiangsu 215300, China.
3. Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou Jiangsu 215163, China.
4. Department of Gastroenterology, Affiliated Hospital of Xuzhou Medical University, Xuzhou Jiangsu 221002, China.
5. Suzhou VersaBio Technologies Co. Ltd., Kunshan Jiangsu 215300, China.
6. Institute of Digestive Diseases, Xuzhou Medical University, Xuzhou Jiangsu 221002, China.

Citation:
Zhao G, Liu X, Liu Y, Ma Y, Yang J, Li H, Xiong S, Fei S, Zheng M, Zhao X. Methylated SFRP2 and SDC2 in stool specimens for Colorectal Cancer early detection: A cost-effective strategy for Chinese population. J Cancer 2021; 12(9):2665-2672. doi:10.7150/jca.52478. https://www.jcancer.org/v12p2665.htm
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Abstract

Graphic abstract

Background: The aim of this study was to evaluate the feasibility of combination of methylated SFRP2 and methylated SDC2 (SpecColon test) in stool specimens for colorectal cancer (CRC) early detection and to optimize the cut-off value of methylated SFRP2 and methylated SDC2.

Methods: Approximately 5 g of stool specimen each was collected from 420 subjects (291 in the training cohort and 129 in the validation cohort). Stool DNA was extracted and bisulfite-converted, followed by detection of methylated level of SFRP2 and SDC2. Youden index was employed to determine the cut-off value.

Results: The whole operating time for stool SpecColon test takes less than 5 hours. The limit of detection of combination of methylated SFRP2 and methylated SDC2 was as low as 5 pg per reaction. The optimized cut-off value was methylated SFRP2 analyzed by 3/3 rule and methylated SDC2 analyzed by 2/3 rule. In the training cohort, the sensitivities of stool SpecColon test for detecting AA and early stage CRC (stage 0-II) were 53.8% (95% CI: 26.1%-79.6%) and 89.1% (95% CI: 77.1%-95.5%) with a specificity of 93.5% (95% CI: 87.2%-96.9%), and the AUC for CRC diagnosis was 0.879 (95% CI: 0.830-0.928). Similar performance was achieved by SpecColon test also in the validation cohort, where its sensitivities for detecting AA and early stage CRC (stage 0-II) were 61.5% (95% CI: 32.3-84.9%) and 88.5% (95% CI: 68.5%-97.0%) with a specificity of 89.5% (95% CI: 74.3-96.7%).

Conclusion: Combined detections of methylated SFRP2 and methylated SDC2 in stool samples demonstrated high sensitivities and specificity for the detection of AA and early stage CRC. Therefore, this combination has the potential to become an accurate and cost-effective tool for CRC early detection.

Keywords: colorectal cancer, stool, mSFRP2, mSDC2, early detection


Citation styles

APA
Zhao, G., Liu, X., Liu, Y., Ma, Y., Yang, J., Li, H., Xiong, S., Fei, S., Zheng, M., Zhao, X. (2021). Methylated SFRP2 and SDC2 in stool specimens for Colorectal Cancer early detection: A cost-effective strategy for Chinese population. Journal of Cancer, 12(9), 2665-2672. https://doi.org/10.7150/jca.52478.

ACS
Zhao, G.; Liu, X.; Liu, Y.; Ma, Y.; Yang, J.; Li, H.; Xiong, S.; Fei, S.; Zheng, M.; Zhao, X. Methylated SFRP2 and SDC2 in stool specimens for Colorectal Cancer early detection: A cost-effective strategy for Chinese population. J. Cancer 2021, 12 (9), 2665-2672. DOI: 10.7150/jca.52478.

NLM
Zhao G, Liu X, Liu Y, Ma Y, Yang J, Li H, Xiong S, Fei S, Zheng M, Zhao X. Methylated SFRP2 and SDC2 in stool specimens for Colorectal Cancer early detection: A cost-effective strategy for Chinese population. J Cancer 2021; 12(9):2665-2672. doi:10.7150/jca.52478. https://www.jcancer.org/v12p2665.htm

CSE
Zhao G, Liu X, Liu Y, Ma Y, Yang J, Li H, Xiong S, Fei S, Zheng M, Zhao X. 2021. Methylated SFRP2 and SDC2 in stool specimens for Colorectal Cancer early detection: A cost-effective strategy for Chinese population. J Cancer. 12(9):2665-2672.

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