Sensitive detection of colorectal cancer in peripheral blood by septin 9 DNA methylation assay

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Robert Grützmann - , University Hospital Carl Gustav Carus Dresden, Department of Visceral, Thoracic and Vascular Surgery (Author)
  • Bela Molnar - , Semmelweis University (Author)
  • Christian Pilarsky - , University Hospital Carl Gustav Carus Dresden, Department of Visceral, Thoracic and Vascular Surgery (Author)
  • Jens K. Habermann - , Universitätsklinikum Schleswig-Holstein - Campus Lübeck (Author)
  • Peter M. Schlag - , Charité – Universitätsmedizin Berlin (Author)
  • Hans D. Saeger - , University Hospital Carl Gustav Carus Dresden, Department of Visceral, Thoracic and Vascular Surgery (Author)
  • Stephan Miehlke - , University Hospital Carl Gustav Carus Dresden, Department of internal Medicine I (Author)
  • Thomas Stolz - , Völklingen (Author)
  • Fabian Model - , Epigenomics AG (Author)
  • Uwe J. Roblick - , Universitätsklinikum Schleswig-Holstein - Campus Lübeck (Author)
  • Hans Peter Bruch - , Universitätsklinikum Schleswig-Holstein - Campus Lübeck (Author)
  • Rainer Koch - , Institute for Medical Informatics and Biometry (Author)
  • Volker Liebenberg - , Epigenomics AG (Author)
  • Theo deVos - , Epigenomics AG (Author)
  • Xiaoling Song - , Epigenomics AG (Author)
  • Robert H. Day - , Epigenomics AG (Author)
  • Andrew Z. Sledziewski - , Epigenomics AG (Author)
  • Catherine Lofton-Day - , Epigenomics AG (Author)

Abstract

Background: Colorectal cancer (CRC) is the second leading cause of cancer deaths despite the fact that detection of this cancer in early stages results in over 90% survival rate. Currently less than 45% of at-risk individuals in the US are screened regularly, exposing a need for better screening tests. We performed two case-control studies to validate a blood-based test that identifies methylated DNA in plasma from all stages of CRC. Methodology/Principal Findings: Using a PCR assay for analysis of Septin 9 (SEPT9) hypermethylation in DNA extracted from plasma, clinical performance was optimized on 354 samples (252 CRC, 102 controls) and validated in a blinded, independent study of 309 samples (126 CRC, 183 controls). 168 polyps and 411 additional disease controls were also evaluated. Based on the training study SEPT9-based classification detected 120/252 CRCs (48%) and 7/102 controls (7%). In the test study 73/126 CRCs (58%) and 18/183 control samples (10%) were positive for SEPT9 validating the training set results. Inclusion of an additional measurement replicate increased the sensitivity of the assay in the testing set to 72% (90/125 CRCs detected) while maintaining 90% specificity (19/183 for controls). Positive rates for plasmas from the other cancers (11/96) and non-cancerous conditions (41/315) were low. The rate of polyp detection (>1 cm) was ∼20%. Conclusions/Significance: Analysis of SEPT9 DNA methylation in plasma represents a straightforward, minimally invasive method to detect all stages of CRC with potential to satisfy unmet needs for increased compliance in the screening population. Further clinical testing is warranted.

Details

Original languageEnglish
Article numbere3759
JournalPloS one
Volume3
Issue number11
Publication statusPublished - 19 Nov 2008
Peer-reviewedYes

External IDs

PubMed 19018278

Keywords

Sustainable Development Goals

ASJC Scopus subject areas