Flat-type neoplasias are more common in the right side of the colon while polypoid-type lesions are more common in the www.selleckchem.com/products/Temsirolimus.html left side. In addition, right-sided colon cancer is more likely to be detected at an advanced stage . Both anatomical and genetic factors result in different specificity and sensitivity according to the localization (left or right side) of the colon tumor. Therefore, the development of a minimally invasive colorectal cancer-specific screening test with sensitivity independent of tumor location would be of great clinical importance. In this study we analyzed SEPT9 sensitivity and specificity for both left- and right-sided colorectal cancer. In addition, we also compared SEPT9 to a routine fecal-based screening method (gFOBT) and a blood-based tumor marker (CEA) since no such study had yet been performed.
Materials and Methods Ethics Statement The study was approved by the local ethics committee and government authorities. Written informed consent was obtained from all patients. Detailed interviews for medical history and physical examinations were performed. (Regional and Institutional Committee of Science and Research Ethics, TUKEB Nr: 116/2008). Study Design, Patients, and Lower Gastrointestinal Endoscopy A total of 93 patients with colorectal cancer (CRC) and 94 healthy controls (no evidence of disease; NED) were included in the study. Exclusion criteria were the following: systemic inflammatory, malabsorptive diseases, acute medical conditions, and other malignant diseases. See Table 1 and Table S1 for detailed demographic data.
CRC patients were divided into two groups depending on the localization of the cancer in relation to the splenic flexure of the colon: left-sided (n=36) and right-sided CRC (n=57). All of the subjects (healthy controls and patients with colorectal cancer) underwent lower endoscopy, during which biopsies were taken for histological examination. In the case of CRC, the patients were stratified by the anatomic appearance of the tumor and then characterized by histopathology. None of the patients with cancer received chemotherapy, radiotherapy, or surgical intervention before endoscopy. The endoscopy in all cases was performed using a videocolonoscope (CF-Q160, Olympus, Hamburg). Peripheral blood samples were taken before colonoscopy using 9.5 ml EDTA tubes (Vacutainer, Becton Dickinson, New Jersey, USA).
For validation purposes, 2��9.5 ml peripheral blood samples were taken from 40 patients (16 NED and 24 CRC). Plasma preparation was done from all of the peripheral blood samples by repeated centrifugation for 12 min at 1,350 rcf and plasma samples were stored at ?80��C until needed. See Figure 1 for study design. Figure 1 Study design and sample number for each Carfilzomib step of the assay. Table 1 Demographic data of patients.