Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jun 15, 2023; 15(6): 1086-1095
Published online Jun 15, 2023. doi: 10.4251/wjgo.v15.i6.1086
Diagnostic value of circular free DNA for colorectal cancer detection
Yao Cui, Lu-Jin Zhang, Jian Li, Yu-Jie Xu, Ming-Yue Liu
Yao Cui, Lu-Jin Zhang, Yu-Jie Xu, Ming-Yue Liu, Department of Oncology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital, Zhengzhou 450003, Henan Province, China
Jian Li, Department of General Surgery, Henan Tumor Hospital, The Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
Author contributions: Cui Y and Liu MY designed the study; Zhang LJ, Li J and Xu YJ performed the research; Cui Y and Li J analyzed the data; Cui Y wrote the manuscript; Cui Y and Liu MY revised the manuscript for final submission; Liu MY is the corresponding author.
Supported by the Henan Medical Science and Technology Research Program, No. LHGJ20210045.
Institutional review board statement: The study was reviewed and approved by the Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital.
Informed consent statement: All study participants, or their legal guardian, provided informed written 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 have no data 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: Ming-Yue Liu, MD, Doctor, Department of Oncology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan University People's Hospital, No. 7 Weiwu Road, Zhengzhou 450003, Henan Province, China. liumingyuezz@163.com
Received: March 13, 2023
Peer-review started: March 13, 2023
First decision: March 28, 2023
Revised: March 29, 2023
Accepted: May 17, 2023
Article in press: May 17, 2023
Published online: June 15, 2023
Processing time: 94 Days and 3.1 Hours
ARTICLE HIGHLIGHTS
Research background

Endoscopy combined with tissue biopsy is currently the gold standard for the early diagnosis of colorectal cancer (CRC), but there are some disadvantages, including cumbersome operation, poor compliance and the invasive nature of testing. The commonly available methods for the early diagnosis of CRC remain insufficient.

Research motivation

The identification of a minimally invasive or noninvasive, sensitive and accurate early diagnostic marker for the clinical detection of CRC is urgently needed. Common biomarkers and circular free DNA may exhibit potential diagnostic value for CRC.

Research objectives

To evaluate the diagnostic value of circular free DNA in CRC.

Research methods

A total of 195 healthy control (HC) individuals and 101 CRC patients (38 in the early CRC group and 63 in the advanced CRC group) were enrolled to generate the model. One hundred HC individuals and 62 patients with CRC (30 early CRC and 32 advanced CRC patients) were included separately to validate the model. CAMK1D was detected by digital PCR. Binary logistic regression analysis was used to establish a joint CAMK1D and CEA diagnostic model for CRC.

Research results

Inclusion of both CEA and CAMK1D in the model produced an area under the curve (AUC) of 0.964 (0.945, 0.982). For the differentiation between the HC group and early CRC group, the AUC was 0.978 (0.960, 0.995), and the sensitivity and specificity were 88.90% and 90.80%, respectively. For the differentiation between the HC group and advanced CRC group, the AUC was 0.956 (0.930, 0.981), and the sensitivity and specificity were 81.30% and 95.90%, respectively. In the validation group, the AUC of the CEA and CAMK1D joint model was 0.906 (0.858, 0.954). For differentiating between the HC group and early CRC group, the AUC was 0.909 (0.844, 0.973), and the sensitivity and specificity were 93.00% and 83.30%, respectively. For differentiating between the HC group and the advanced CRC group, the AUC was 0.904 (0.849, 0.959), and the sensitivity and specificity were 93.00% and 75.00%, respectively.

Research conclusions

We evaluated the diagnostic value of circular free CAMK1D DNA for differentiating between HC individuals and CRC patients and demonstrated that CAMK1D may represent a potential diagnostic biomarker for CRC detection.

Research perspectives

Further analysis should use the colorectal polyp group to validate the diagnostic model in future studies.