1. Enhancing Colorectal Cancer Screening with Droplet Digital PCR Analysis of Fusobacterium nucleatum in Fecal Immunochemical Test Samples.
- Author
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Datorre JG, Dos Reis MB, de Carvalho AC, Porto J, Rodrigues GH, Lima AB, Reis MT, Hirai W, Hashimoto CL, Guimarães DP, and Reis RM
- Subjects
- Humans, Female, Male, Middle Aged, Aged, Adenoma diagnosis, Adenoma microbiology, Occult Blood, Fusobacterium Infections diagnosis, Fusobacterium Infections microbiology, DNA, Bacterial analysis, DNA, Bacterial isolation & purification, DNA, Bacterial genetics, Colonoscopy methods, Sensitivity and Specificity, Biomarkers, Tumor analysis, Biomarkers, Tumor genetics, Colorectal Neoplasms diagnosis, Colorectal Neoplasms microbiology, Fusobacterium nucleatum isolation & purification, Fusobacterium nucleatum genetics, Early Detection of Cancer methods, Feces microbiology, Feces chemistry, Polymerase Chain Reaction methods
- Abstract
Fecal immunochemical test (FIT) followed by colonoscopy in positive cases is commonly used for population-based colorectal cancer screening. However, specificity of FIT for colorectal cancer is not ideal and has poor performance for advanced adenoma detection. Fecal Fusobacterium nucleatum (Fn) detection has been proposed as a potential noninvasive biomarker for colorectal cancer and advanced adenoma detection. We aimed to evaluate the diagnostic performance of Fn detection using droplet digital PCR (ddPCR) in FIT samples from individuals enrolled in a colorectal cancer screening program with colorectal adenoma or cancer. We evaluated Fn presence in DNA isolated from FIT leftover material of 300 participants in a colorectal cancer screening program using ddPCR. The Fn DNA amount was classified as Fn-low/negative and Fn-high, and the association with patients' clinicopathological features and accuracy measurements was calculated. Fn-high levels were more prevalent in FIT-positive (47.2%, n = 34 of 72) than FIT-negative samples (28.9%, n = 66 of 228; P < 0.04). Among FIT-positive samples, high Fn levels were significantly more frequent in patients with cancer (CA, n = 8) when compared to normal (NT, n = 16; P = 0.02), non-advanced adenomas (NAA, n = 36; P = 0.01), and advanced adenomas (AA, n = 12; P = 0.01). Performance analysis of Fn in FIT-positive samples for colorectal cancer detection yielded an AUC of 0.8203 [confidence interval (CI), 0.6464-0.9942], with high sensitivity (100%) and specificity of 50%. Concluding, we showed the feasibility of detecting Fn in FIT leftovers using the ultrasensitive ddPCR technique. Furthermore, we highlighted the potential use of Fn levels in fecal samples to ameliorate colorectal cancer detection. Prevention Relevance: Fusobacterium nucleatum detection by droplet digital PCR could prioritize the selection of fecal immunochemical test-positive individuals who might benefit the most from the colonoscopy procedure., (©2024 American Association for Cancer Research.)
- Published
- 2024
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