Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Apr 15, 2024; 16(4): 1361-1373
Published online Apr 15, 2024. doi: 10.4251/wjgo.v16.i4.1361
Effectiveness of fecal DNA syndecan-2 methylation testing for detection of colorectal cancer in a high-risk Chinese population
Wen-Feng Luo, Yu-Ting Jiao, Xiao-Ling Lin, Ying Zhao, Sheng-Bo Wang, Jian Shen, Jie Deng, Yu-Feng Ye, Ze-Ping Han, Fang-Mei Xie, Jin-Hua He, Yu Wan
Wen-Feng Luo, Xiao-Ling Lin, Ying Zhao, Jian Shen, Ze-Ping Han, Fang-Mei Xie, Jin-Hua He, Central Laboratory of Panyu Central Hospital, Guangzhou Panyu Central Hospital, Guangzhou 511400, Guangdong Province, China
Yu-Ting Jiao, South China Normal University-Panyu Central Hospital Joint Laboratory of Translational Medical Research, Guangzhou Panyu Central Hospital, Guangzhou 511400, Guangdong Province, China
Sheng-Bo Wang, Yu Wan, Digestive Disease Center, Guangzhou Panyu Central Hospital, Guangzhou 511400, Guangdong Province, China
Jie Deng, Shunde Vocational and Technical College, Foshan 528300, Guangdong Province, China
Yu-Feng Ye, Medical Imaging Institute of Panyu, Guangzhou Panyu Central Hospital, Guangzhou 511400, Guangdong Province, China
Co-first authors: Wen-Feng Luo and Yu-Ting Jiao.
Co-corresponding authors: Wen-Feng Luo and Yu Wan.
Author contributions: Luo WF and Jiao YT contributed equally to this work; Luo WF and Wan Y were co-corresponding authors; Luo WF, Jiao YT, and Wan Y contributed to conceptualization, visualization, initial draft writing, funding acquisition, review and editing; Luo WF, Jiao YT, Wang SB, and Deng J proposed and designed the study; Lin XL, Shen J, and Xie FM performed analyses; Zhao Y, Han ZP, and Han ZP wrote the initial draft; Jiao YT, Ye YF, He JH, and Wan Y revised the manuscript; and all authors read and approved the final manuscript.
Supported by the Science and Technology Program of Panyu Central Hospital, No. PY-2023-003; the Science and Technology Program of Panyu, No. 2020-Z04-054; the Science and Technology Project of the Guangzhou Health Commission, No. 20211A011114; the Science and Technology Program of Guangzhou, No. 202002020023; the General University Youth Innovative Talent Project of Guangdong Province, No. 2022KQNCX281; the Guangdong Provincial Key Field Special Project for Ordinary Colleges and Universities, No. 2023ZDZX2097; and the Foshan Engineering Technology Research Center for Prepared Food Processing and Quality Evaluation, No. 2022-KJZX113.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Panyu Central Hospital in China (Approval No. [2019]62).
Informed consent statement: The informed consent was obtained from all study participants.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
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: Wen-Feng Luo, MS, PhD, Assistant Professor, Doctor, Central Laboratory of Panyu Central Hospital, Guangzhou Panyu Central Hospital, No. 8 East Fuyu Road, Qiaonan Street, Panyu District, Guangzhou 511400, Guangdong Province, China. luowenfeng163@163.com
Received: December 21, 2023
Peer-review started: December 21, 2023
First decision: December 28, 2023
Revised: January 12, 2024
Accepted: February 7, 2024
Article in press: February 7, 2024
Published online: April 15, 2024
Processing time: 112 Days and 1.9 Hours
ARTICLE HIGHLIGHTS
Research background

Colorectal cancer (CRC) is a prevalent and life-threatening malignant tumor affecting the digestive system globally. Testing for syndecan-2 methylation (mSDC2) has emerged as a widely used screening tool for early detection of CRC in stool and serum samples.

Research motivation

Our findings provide evidence-based data concerning diagnostic and screening methods relevant to a Chinese population at high-risk population for CRC.

Research objectives

To validate the effectiveness of fecal mSDC2 testing in the detection of CRC among a high-risk Chinese population.

Research methods

A high-risk Chinese cohort composed of 1130 individuals 40-79 years of age was selected for evaluation using the fecal mSDC2 test. Sensitivity and specificity to CRC, advanced adenoma (AA) and advanced colorectal neoplasia (ACN) were quantified. High-risk factors for the incidence of colorectal lesions were analyzed; a logistic regression model was subsequently constructed to better reflect the efficacy of fecal mSDC2 testing.

Research results

According to criteria previously established, 1035 high-risk individuals were included in analyses. Among them, 16 CRC cases (1.55%), 65 AA cases (6.28%), 189 non-advanced adenoma cases (18.26%), and 150 cases of polyps (14.49%) were successfully identified on colonoscopy and pathological examination. The sensitivities of mSDC2 testing for CRC and AA were 87.50% and 40.00%, respectively; the specificity for subjects in the “others” group was 95.61%. The positive predictive values of mSDC2 testing for CRC, AA, and ACN were 16.09%, 29.89% and 45.98%, respectively. In addition, negative predictive value of mSDC2 testing for CRC was 99.79%. Positivity on mSDC2 testing is a significant risk factor for the development of ACN (P < 0.001) after adjusting for other high-risk covariates.

Research conclusions

The results of this CRC screening study revealed that offering patients a combination of fecal mSDC2 testing and colonoscopy is ideal for facilitating early detection of CRC among a high-risk Chinese population. CRC screening study revealed that offering patients a combination of fecal mSDC2 testing and colonoscopy is ideal for facilitating early detection of CRC among a high-risk Chinese population.

Research perspectives

Detection of stool mSDC2 offers great promise for early and effective CRC screening.