Background:Early diagnosis represents the best opportunity for cure of colorectal cancer. Current screening programmes use faecal occult blood testing for screening, which has limited sensitivity and poor specificity.Methods:In this study we looked at a series of previously described diagnostic markers utilising circulating free DNA (cfDNA), with a preparation method allowing small DNA fragments to be isolated. The Circulating free DNA was isolated from samples obtained from 85 patients, including 35 patients without endoscopic abnormality, a group of 26 patients with benign colorectal adenomas, and 24 patients with colorectal carcinomas. In each case, polymerase chain reaction (PCR) was performed for Line1 79 bp, Line1 300 bp, Alu 115 bp, Alu 247 bp, and mitochondrial primers. In addition, carcinoembryonic antigen (CEA) was measured by ELISA. Each marker was analysed between normal, polyp, and cancer populations, and the best performing analysed in combination by logistic regression.Results:The best model was able to discriminate normal from populations with adenoma or carcinoma using three DNA markers and CEA, showing an area under the receiver operator characteristic (ROC) curve of 0.855 with a positive predictive value of 81.1% for polyps and cancer diagnosis.Conclusion:These circulating markers in combination with other markers offer the prospect of a simple blood test as a possible secondary screen for colorectal cancers and polyps in patients with positive faecal occult blood tests.
The size/morphology/site/access scoring system is easy to use and provides valuable information on the lesion complexity and success and complication rates of endoscopic resection. This can be used for service planning, training endoscopists, and providing prognostic information for patients.
The toxin fluoroacetate occurs naturally in many southwestern Australian species of the legume genera Gastrolobium and Oxylobium. No fluoroacetate-bearing species are known from southeastern Australia. Herbivores have evolved a high level of genetic tolerance to this toxin; this has persisted in some mammalian herbivores whose range now extends beyond the range of the toxic plants. Other species of mammals have acquired tolerance since extending their range into south-western Australia. This tolerance can be used as a genetic marker to identify the geographic origin and trace the subsequent spread of herbivorous mammals in southern Australia. In this paper, this marker has been used to clarify the recent evolutionary history of the western grey kangaroo, the tammar wallaby and the bush rat.
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