Emerging diagnostic and prognostic biomarkers for colorectal cancer
Emerging diagnostic and prognostic biomarkers for colorectal cancer
Ali Rezaei,1Ali Yousefzadeh Dastjerd,2Ali Amirian,3Zeinab Shirvani-Farsani,4,*
1. Department of Cell and Molecular Biology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran 2. Department of Microbiology and microbial biotechnology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran 3. Department of Animal sciences and marine biology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran 4. Department of Cell and Molecular Biology, Faculty of Life Sciences and Biotechnology, Shahid Beheshti University, Tehran, Iran
Introduction: Colorectal cancer is one of the leading causes of death, being the third most frequently diagnosed cancer worldwide. Despite advances in detection and management through surgery, chemotherapy, and immunotherapy. Precisely diagnosing colorectal cancer at early stages is critical to increasing both the chances of determining the most effective treatment method and the patient’s survival. The identification and validation of effective biomarkers for colorectal cancer could lead to improved screening, diagnosis, and treatment outcomes for patients. Nevertheless, the current biomarkers have some challenges. Finding a biomarker or a panel of biomarkers that have the desirable specificity and sensitivity remains an unanswered question. In this review, we will discuss emerging diagnostic and prognostic biomarkers for colorectal cancer.
Methods: To conduct this research, we studied several articles regarding “colorectal cancer biomarkers” on PubMed, ResearchGate, and several other publishers’ websites.
Results: Conventional biomarkers, such as carcinoembryonic antigen (CEA) which is a protein and is sampled from stool showed 43% sensitivity and 87% specificity, or CRMP-2 has 61% sensitivity and 65% specificity, have limitations in terms of sensitivity and specificity but emerging biomarkers, including long non-coding RNAs (lncRNAs), microRNAs and circulating tumor cells, show promise in improving early detection and prognosis. For example, 91H which is a lncRNA, is associated with proliferation, migration, and invasion of the tumor. DANCR, another lncRNA, has been in relation to tumor progression and metastasis. Also, many miRNAs show dysregulation in CRC patients. For instance, miR-30a whose target gene is metadherin, miR-744 whose target gene is Notch1, miR-383 whose target gene is PAX6, and miR-1271 whose target gene is Capn4, are all downregulated in CRC cases. These miRNAs inhibit cell migration, cell proliferation, and invasion. In a study, a panel of three lncRNA including 91H, PVT-1, and MEG3 was used to test their detection performance. The results were 82.80% for sensitivity and 78.60% for specificity. In another paper, a 2-lncRNA panel including ATB and CCAT1 was used to result in 82.00% sensitivity and 75.00% specificity. For mRNA, in a study, a panel of expression of several mRNAs containing CEA, EpCAM, CK19, MUC1, EGFR, and C-Met genes was used with 87.00% sensitivity and 85.00% specificity. In another study, two mRNAs comprising TSPAN8 and LGALS4 genes exhibited 92.50% sensitivity and 67.2% specificity. These results show that in terms of functionality, we can get good answers from several other novel biomarker types.
Conclusion: Although these novel biomarkers might not show a hopeful result when used alone, when a panel of several biomarkers is used, they can cover others’ weaknesses and add on their strength to come up with a desired outcome. Evaluation of these biomarkers might require more research and clinical trials to validate their clinical utility. Expanding our understanding of this field promises the discovery of high-performance and affordable biomarkers to use on patients with colorectal cancer. The focus of our study is on potential biomarkers that can be used as a diagnostic and/or prognostic tool for CRC patients.