Diagnostic Value and Clinical Significance of Methylated SEPT9 for Colorectal Cancer: A Meta-Analysis

Abstract

Background This meta-analysis aimed to clarify the diagnostic role of plasma methylated SEPT9 (mSEPT9) in colorectal cancer (CRC) and examined its association with CRC. Material/Methods A systematic review was conducted prior to July 2018. Summary sensitivity, specificity, and positive and negative likelihood ratio (PLR/NLR) were calculated for the diagnostic value of mSEPT9 for CRC. The areas under the receiver operating curves (AUCs) were used to summarize the overall test performance. Results Twenty-two studies with 2271 CRC patients were enrolled. The summary sensitivity, specificity, PLR, NLR, DOR, and AUC of the overall analysis of mSEPT9 were 0.69, 0.92, 8.1, 0.34, 24, and 0.89, respectively. Subgroup and meta-regression analyses demonstrated that the diagnostic value was higher for the Epi proColon 2.0 assay, Asian ethnicity, and mSEPT9 test combined with fecal occult blood test (FOBT) or fecal immunochemical test (FIT) than for other test methods, white ethnicity, and mSEPT9 test alone. The rate of mSEPT9 positivity was higher in advanced CRC cases compared with early-stage CRC cases, and was higher in CRC cases than in adenoma cases. No significant difference in mSEPT9 positivity rate was found between left- and right-sided CRC. Conclusions Plasma mSEPT9 has a high diagnostic value for CRC, especially on the newly developed Epi proColon test 2.0 method. The diagnostic sensitivity is superior among Asians compared to whites, and the combination of mSEPT9 and FOBT/FIT has a better performance than mSEPT9 alone. Finally, the expression of mSEPT9 is associated with CRC stage but not with location.

A Pilot Study Investigating the Expression Levels of Pluripotency-Associated Genes in Rectal Swab Samples for Colorectal Polyp and Cancer Diagnosis and Prognosis

“…Comparing with the other tests, the sensitivity of such blood test was relatively poor, with the value of 35% to 77% achieved, depending on the stages of CRC [89]. Although a recent meta-analysis suggested the second-generation Epi proColon test 2.0 showed better sensitivity of 74% for CRC, such a result did not outperform the available tests [90]. Besides, Epi proColon showed a weak sensitivity of 11% for advanced adenomas, suggesting that it is unable to identify precancerous lesions.…”

Value of Serum NEUROG1 Methylation for the Detection of Advanced Adenomas and Colorectal Cancer

“…The PRESEPT study [ 26 ], conducted in a real screening scenario, indicated 48.2% sensitivity for CRC with 91.5% specificity. The sensitivity of the test was reported to be increased, especially among Asians [ 27 ]. However, sensitivity for AA was very low (11.2%), slightly higher than the false positive rate for all non-cancer individuals [ 26 ], indicating no utility in detecting precancerous lesions [ 28 ].…”

Fecal DNA Testing of TWIST1 Methylation Identifies Patients With Advanced Colorectal Adenoma Missed by Fecal Immunochemical Test for Hemoglobin

“…COLVERA is not intended for screening but can be used with carcinoembryonic antigen for surveillance of recurrent colorectal cancer after primary treatment ( 20 ). The Epi proColon 2.0 test can be used for screening, and its sensitivity for colorectal cancer is 61%–83% with specificity of 82%–98% ( 21 ). However, the sensitivity falls to 27% for advanced adenoma ( 22 ).…”