Background Colorectal cancer (CRC) is one of the most frequently diagnosed tumors worldwide with high mortality and morbidity. There is an urgent need for biomarkers to improve the outcomes and early detection of CRC. The sensitivity of traditional CRC tumor markers (carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9)) is not ideal. The levels of leucine-rich-alpha-2-glycoprotein 1 (LRG1) and stem cell factor (SCF) were evaluated, but the combined value of both markers is unclear. This case-control study included four groups: CRC patients before treatments (n = 22), CRC patients after treatments (n = 26), 20 patients with benign tumor, and 20 healthy subjects. Levels of routine biochemical and hematological markers, traditional tumor markers (CA19.9 and CEA), and candidate markers (LRG1 and SCF) were determined. Univariate and multivariate logistic regression analysis and area receiver-operating characteristic analysis (ROC) were used for evaluation the diagnostic performances of single and combined markers. Results No significance difference in traditional tumor markers CEA, CA 19.9, and neutrophil–lymphocyte ratio (NLR) were found among study groups. SCF, LRG1, and platelet–lymphocyte ratio (PLR) were significantly decreased (p < 0.05) in non-treated CRC patients than after treated CRC. The combination between SCF and LRG1 showed highly significant difference in CRC patients compared with benign, healthy subjects, and among CRC groups (treated and non-treated) (p < 0.0001). The highest areas under curve (AUCs) were observed when LRG1 was used as a single predictor for discriminating CRC from healthy (0.87), benign (0.84), and non-treated CRC vs treated CRC (0.82). AUCs were jumped to 0.90, 0.84, and 0.84 when LRG1 and SCF were combined. Conclusion Our study revealed that LRG1 and SCF were potential diagnostic and follow-up markers for CRC.
Globally, colorectal cancer (CRC) is one of the most often diagnosed solid tumors, with a significant death and morbidity rate. CRC biomarkers are desperately needed for early detection. Traditional CRC tumor markers do not have the best diagnostic performance. The levels of leptin and vitamin D were evaluated. CRC patients before treatment (n=16), CRC patients after treatment (n=14), and 20 patients with benign tumors were included in this case-control study. ELISA was used to determine the levels of traditional tumor markers (CA19.9 and CEA) as well as candidate markers (leptin and vitamin D). Using area receiver-operating characteristic analysis (AUC), the diagnostic performance of single and combination markers was assessed (ROC). The levels of CEA and CA 19.9 in the three groups studied were not significantly different. Vitamin D and leptin were significantly decreased (p= 0.03 and p= 0.02; respectively) in CRC patients than after benign patients. A novel combination, based on the combination of vitamin D and leptin was developed for CRC diagnosis using stepwise multivariate discriminant analysis (MDA). The combination can be represented as = (4.65vitamin D ((ng/ml)) × 0.009 + Leptin (ng/ml) × 0.441). AUCs were reported when leptin was used as a single biomarker for distinguishing CRC from benign (0.78) and non-treated CRC from treated CRC (0.67).When leptin and vitamin D were combined, the AUCs increased to 0.84 and0.72, respectively. Conclusion: Leptin and vitamin D were shown to be promising diagnostic and follow-up indicators for CRC in our investigation.
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