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iNature
Colorectal cancer (CRC) is one of the most common malignancies and is usually detected
late in the clinic.
Due to the lack of reliable biomarkers, currently available CRC diagnostic tools are either invasive or insensitive
to early lesions.
On January 5, 2023, Liu Dingbin and Xu Chen of Nankai University jointly published an online newsletter entitled " Identification of faecal extracellular vesicles as novel biomarkers for the non-invasive diagnosis and prognosis of colorectal cancer", This study suggests that the identification of fecal extracellular vesicles can be used as novel biomarkers for the non-invasive diagnosis and prognosis of colorectal cancer
.
The study found that extracellular vesicles (EVs) in the feces of CRC patients can serve as effective biomarkers for the non-invasive diagnosis and prognosis of CRC
.
This finding is based on the identification of two transmembrane proteins, CD147 and A33, on fecal-derived EVs (fEVs) that are intrinsically associated
with CRC.
The test results showed that the levels of CD147 and A33 in the fEVs of colorectal cancer patients were elevated, which was significantly different from
that of healthy donors.
The clinical sensitivity of CD147/A33-enriched EVs was 89%, much higher than that of carcinoembryonic antigen (CEA), a clinically established serum biomarker for the diagnosis of CRC
.
In addition, analysis of longitudinal stool samples showed that CD147/A33-enriched fEVs could be used to track the prognosis
of CRC.
Due to the high adherence to stool testing, CD147/A33-rich fEVs can serve as next-generation CRC biomarkers for large-scale, non-invasive CRC screening and real-time monitoring of patient outcomes
during clinical interventions.
of cancer death.
Most CRCs develop from precancerous lesions such as adenomatous polyps or stalkless serrated lesions
.
It usually takes a long time (10-20 years) to become cancerous, so there are many avenues
for detecting precancerous lesions and early cancer.
With the assistance of early cancer detection and surgical removal of lesions, it can effectively reduce the mortality
caused by CRC.
It is estimated that the 5-year relative survival rate of CRC patients has decreased dramatically from ~ 90% in stage I and II to <20%
in stage III and IV.
Therefore, it is important
to use appropriate diagnostic methods for early CRC screening in the appropriate age population.
At present, colonoscopy is still the gold standard for colorectal cancer diagnosis and has been widely used for colorectal cancer screening
.
However, colonoscopic diagnosis is strongly invasive, resulting in poor participant compliance
.
In addition, the accuracy of colonoscopy diagnosis depends largely on the proficiency and experience
of the operator.
Carcinoembryonic antigen (CEA) is a recognized serum marker for clinical diagnosis of CRC, monitoring treatment, and recognition of recurrence
.
However, because CEA levels are also upregulated in other malignancies such as breast, lung, and gastric cancers, their sensitivity and specificity remain limited
.
Fecal immunochemical testing (FIT) and multi-target stool DNA (mstDNA) testing, which detect hemoglobin and DNA mutations in stool samples, respectively, are two typical non-invasive methods
for CRC screening.
However, false-positive results due to other disorders are frequent
.
In order for stool samples to be useful for the diagnosis of colorectal cancer, there is an urgent need to discover new biomarkers with high clinical sensitivity and
specificity.
Analysis of CD147 and A33 in clinical fecal specimens EVs (Image from Journal of Extracellular Vesicles) Extracellular vesicles (EVs) are nano- and microvesicles secreted by cells and released into body fluids such as serum, urine, and saliva
.
EVs inherit specific molecular information from parent cells and are therefore seen as promising cancer biomarkers for "liquid biopsies
.
" Plasma EVs have been widely used in cancer diagnosis and prognosis
.
Since blood circulates throughout the body, plasma EVs come from different cells and tissues
.
Therefore, the limited number of EVs secreted by the lesion is usually overwhelmed
by the large number of healthy EVs in the plasma.
Body fluids in direct contact with lesions may contain more pathologically relevant EVs
than circulating blood.
For example, urine and saliva EVs show higher sensitivity and specificity
than corresponding plasma EVs when diagnosing kidney and oral diseases.
Due to the unique connection between feces and intestines, similar to the relationship between urine and kidneys and saliva and oral cavity, the relationship between feces and intestines has great potential
as a valuable biomarker for diagnosing CRC.
In conclusion, the study shows that fEV can be used as a novel biomarker in the diagnosis and prognosis of colorectal cancer in a completely non-invasive manner, with high clinical sensitivity and sensitivity, providing new opportunities
for large-scale colorectal cancer screening.
This discovery fills the gap between EVs and clinical diagnosis and will promote the application of EVs in basic research and clinical diagnosis of
colorectal cancer.
Original link: https://onlinelibrary.
wiley.
com/doi/full/10.
1002/jev2.
12300
—END—
The content is [iNature]
