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Multiplex screening of 275 plasma protein biomarkers to identify a signature for early detection of colorectal cancer

Authors: Korbinian Weigl; Kaja Tikk; Petra Schrotz-King; Megha Bhardwaj; Megha Bhardwaj; Axel Benner; Hermann Brenner;

Multiplex screening of 275 plasma protein biomarkers to identify a signature for early detection of colorectal cancer

Abstract

Blood‐based protein biomarkers may be an attractive option for early detection of colorectal cancer (CRC). Here, we used a two‐stage design to measure 275 protein markers by proximity extension assay (PEA), first in plasma samples of a discovery set consisting of 98 newly diagnosed CRC cases and 100 age‐ and gender‐matched controls free of neoplasm at screening colonoscopy. An algorithm predicting the presence of early‐ or late‐stage CRC was derived by least absolute shrinkage and selection operator regression with .632+ bootstrap method, and the algorithms were then validated using PEA again in an independent validation set consisting of participants of screening colonoscopy with and without CRC (n = 56 and 102, respectively). Three different signatures for all‐, early‐, and late‐stage CRC consisting of 9, 12, and 11 protein markers were obtained in the discovery set with areas under the curves (AUCs) after .632 + bootstrap adjustment of 0.92, 0.91, and 0.96, respectively. External validation among participants of screening colonoscopy yielded AUCs of 0.76 [95% confidence interval (95% CI), 0.67–0.84], 0.75 (95% CI, 0.62–0.87), and 0.80 (95% CI, 0.68–0.89) for all‐, early‐, and late‐stage CRC, respectively. Although the identified protein markers are not competitive with the best available stool tests, these proteins may contribute to the development of powerful blood‐based tests for CRC early detection in the future.

Keywords

Male, colorectal cancer, Sensitivity and Specificity, diagnostic biomarkers, Biomarkers, Tumor, Humans, early detection, RC254-282, Research Articles, Early Detection of Cancer, Aged, Neoplasm Staging, Aged, 80 and over, screening, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Blood Proteins, Colonoscopy, Middle Aged, ROC Curve, sensitivity and specificity, Area Under Curve, Case-Control Studies, proximity extension assay, Female, Colorectal Neoplasms, Algorithms, Metabolic Networks and Pathways

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    citations
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    26
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Average
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
26
Top 10%
Average
Top 10%
Green
gold