Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Aug 15, 2022; 14(8): 1562-1573
Published online Aug 15, 2022. doi: 10.4251/wjgo.v14.i8.1562
Evaluation of the diagnostic value of serum-based proteomics for colorectal cancer
Hui-Juan Wang, Yi-Bin Xie, Peng-Jun Zhang, Tao Jiang
Hui-Juan Wang, Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University, Beijing 100020, China
Yi-Bin Xie, Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
Peng-Jun Zhang, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Interventional Therapy Department, Peking University Cancer Hospital and Institute, Beijing 100142, China
Tao Jiang, Medical Innovation Research Division of Chinese PLA General Hospital, Beijing 100853, China
Author contributions: Wang HJ and Jiang T designed the study; Wang HJ and Zhang PJ performed the research; Wang HJ and Xie YB analyzed the date; Wang HJ wrote the paper; Jiang T and Zhang PJ revised the manuscript for final submission; Wang HJ and Xie YB contributed equally to this study; Zhang PJ and Jiang T are the co-corresponding authors; and all authors have read and approve the final manuscript.
Supported by National Key Research and Development Program of China, No. 2020YFC2002700; CAMS Initiative for Innovative Medicine, No. 2016-I2M-1-007; National Natural Science Foundation of China, No. 81972010, and No. 81500003.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of First Center of Chinese PLA General Hospital.
Informed consent statement: All study participants or their legal guardian provided written informed consent prior to study enrollment.
Conflict-of-interest statement: We declare that we have no financial or personal relationships with other individuals or organizations that can inappropriately influence our work and that there is no professional or other personal interest of any nature in any product, service and/or company that could be construed as influencing the position presented in or the review of the manuscript.
Data sharing statement: We declared that no date was to share.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tao Jiang, MD, Doctor, Medical Innovation Research Division of Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing 100853, China. laoai2915@163.com
Received: March 8, 2022
Peer-review started: March 8, 2022
First decision: April 7, 2022
Revised: April 13, 2022
Accepted: July 18, 2022
Article in press: July 18, 2022
Published online: August 15, 2022
Processing time: 155 Days and 4 Hours
Abstract
BACKGROUND

Colorectal cancer (CRC) is a highly malignant cancer with a high incidence and mortality in China. It is urgent to find a diagnostic marker with higher sensitivity and specificity than the traditional approaches for CRC diagnosis.

AIM

To provide new ideas for the diagnosis of CRC based on serum proteomics.

METHODS

Specimens from 83 healthy people, 62 colon polyp (CRP) patients, and 101 CRC patients were analyzed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The diagnostic value of the profiles of differentially expressed proteins was then analyzed.

RESULTS

Compared with the healthy control group, CRC patients had elevated expression of 5 proteins and reduced expression of 14 proteins. The area under the curve (AUC) for a differentially expressed protein with a mass-to-charge ratio of 2022.34 was the largest; the AUC was 0.843, which was higher than the AUC of 0.717 observed with carcinoembryonic antigen (CEA), and the sensitivity and specificity of this identified marker were 75.3% and 79.5%, respectively. After cross-validation, the accuracy of diagnosis using levels of this differentially expressed protein was 82.37%. Compared with the CRP group, the expression of 3 proteins in the serum of CRC patients was elevated and 11 proteins were expressed at reduced levels. Proteins possessing mass-to-charge ratio values of 2899.38 and 877.3 were selected to establish a classification tree model. The results showed that the accuracy of CRC diagnosis was 89.5%, the accuracy of CRP diagnosis was 81.6%, and the overall accuracy of this approach was 86.3%. The overall sensitivity and specificity of diagnosis using the proteomics approach were 81.8% and 66.75%, respectively. The sensitivities and specificities of diagnoses based on CEA and carbohydrate antigen 19-9 expression were 55.6% and 91.3% and 65.4% and 65.2%, respectively.

CONCLUSION

We demonstrated that serum proteomics may be helpful for the detection of CRC, and it may assist clinical practice for CRC diagnosis.

Keywords: Colorectal cancer; Colorectal polyps; Serum; Proteomics; Diagnostic value

Core Tip: At present, the main techniques for proteomic research are mass spectrometry and two-dimensional gel electrophoresis. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry can analyze not only cells and tissues but also powders, solutions, and membranes. This technology is an ideal platform for the identification of tumor markers to be used in clinical practice. In this study, by using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, we analyzed the serum protein expression profiles of healthy controls, colorectal polyp patients, and colorectal cancer patients to find differentially expressed protein peaks, and aimed to evaluate the diagnostic value of serum proteomics for colorectal cancer.