Serum angiogenin as a potential biomarker for early detection of colorectal adenomas and colorectal cancer

Abstract

Although colorectal cancer (CRC) is one of the most common causes of cancer mortality, early-stage detection dramatically improves survival rate. To explore the feasibility of serum angiogenin (ANG) as a biomarker for early detection of colorectal neoplasia, we collected serum samples from 781 participants, including 369 patients with CRC, 133 with colorectal adenoma and 279 healthy controls. We examined the levels of serum ANG by ELISA, calculated the diagnostic accuracy of ANG by plotted receiver operating characteristic curves (ROCs), and compared it with those obtained by carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9). We also analyzed the relationship between serum ANG level and TNM stage in CRC patients. The results showed that ANG serum levels were significantly elevated in patients with colorectal adenomas and CRC (P < 0.01). The area under the ROC curve (AUC) for ANG in distinguishing CRC patients from healthy controls was 0.740 [95% confidence interval (CI): 0.705-0.744], comparable to that of CEA (0.770; 95% CI: 0.735-0.802; P = 0.26) but significantly higher than that of CA19-9 (0.636; 95% CI: 0.598-0.674, P < 0.01), with much higher sensitivity (67.75%) than CEA (36.86%) or CA19-9 (12.20%). We observed no significant differences in ANG serum levels among CRCs at different TNM stages. Furthermore, sensitivity and specificity of ANG for distinguishing colorectal adenomas patients from healthy controls were 66.20% and 64.90%, respectively. ANG has the potential to serve as a serum biomarker for early detection of colorectal neoplasia.

Angiogenin and Copper Crossing in Wound Healing

“…Nevertheless, the widespread expression of ANG in several human tissues and its presence in fluids, namely plasma [ 48 ], the tumor microenvironment [ 49 ] and amniotic [ 50 ] and cerebrospinal liquids [ 51 ], suggests its participation not merely in neovascularization but also in further physiological and pathological processes, including neuroprotection [ 52 ], inflammation [ 53 ], the immune response [ 54 ], micro-biocidal activity [ 55 ] and reproduction [ 56 ]. Accordingly, mutations of the gene encoding for ANG have been found in patients affected by neurodegenerative disorders, such as amyotrophic lateral sclerosis (ALS) [ 57 ] and Parkinson’s disease (PD) [ 58 ], while an increased concentration of ANG has been measured in patients with ulcerative and Crohn’s diseases (CrD) [ 59 ].…”

Angiogenin Levels and Their Association with Cardiometabolic Indices Following Vitamin D Status Correction in Saudi Adults

“…ANG is a multifunctional protein known to induce blood vessel formation and is a potential biomarker for cardiac deterioration [20] and several types of cancers [24][25][26].…”

“…ANG is a multifunctional protein known to induce blood vessel formation and is a potential biomarker for cardiac deterioration [ 20 ] and several types of cancers [ 24 , 25 , 26 ]. Within this context, we studied the effects of improving vitamin D status in circulating ANG and whether it is associated with other known cardiometabolic indices in vitamin D-deficient adults.…”

Colorectal Cancer Diagnosis: The Obstacles We Face in Determining a Non-Invasive Test and Current Advances in Biomarker Detection

“…Another recently reported serum marker is angiogenin. It has a sensitivity of 66.2% and specificity of 64.9% at ruling out CRC [138]. However, the specificity rate remains too low for it to be used as a screening tool for the early detection of CRC.…”