Basic Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 28, 2017; 23(12): 2159-2167
Published online Mar 28, 2017. doi: 10.3748/wjg.v23.i12.2159
Diagnostic value evaluation of trefoil factors family 3 for the early detection of colorectal cancer
Hui Xie, Jian-Hai Guo, Wei-Min An, Sheng-Tao Tian, Hai-Peng Yu, Xue-Ling Yang, Hua-Ming Wang, Zhi Guo
Hui Xie, Hai-Peng Yu, Xue-Ling Yang, Zhi Guo, Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Cancer Research Center, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300070, China
Hui Xie, Sheng-Tao Tian, Hua-Ming Wang, Department of interventional therapy, 302 Hospital of People’s Liberation Army, Beijing 100039, China
Jian-Hai Guo, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Interventional Therapy Department, Peking University Cancer Hospital and Institute, Beijing 100142, China
Wei-Min An, Center of radiology, 302 Hospital of People’s Liberation Army, Beijing 100039, China
Author contributions: Xie H, Guo JH, Wang HM and Guo Z designed the study; Xie H, Guo JH, Yu HP and Yang XL performed the research; Xie H, An WM and Tian ST analyzed the data; Xie H and Guo JH wrote the paper; Wang HM and Guo Z revised the manuscript for final submission; Xie H and Guo JH contributed equally to this study; Wang HM and Guo Z are the co-corresponding authors.
Supported by The Capital Health Development Special Scientific Research Projects, No. 2014-2-2154; and National Natural Science Foundation of China, No. 81471761 and No. 81501568.
Institutional review board statement: The study was reviewed and approved by the 302 Hospital of People’s Liberation Army and Institutional Review Board.
Informed consent statement: All study participants or their legal guardians provided written informed consent prior to study enrollment.
Conflict-of-interest statement: We declare that we have no financial or personal relationships with other individuals or organizations that can inappropriately influence our work and that there is no professional or other personal interest of any nature in any product, service and/or company that could be construed as influencing the position presented in or the review of the manuscript.
Data sharing statement: The technical appendix, statistical code, and dataset are available from the corresponding author at guoztj@126.com and hmwang302@126.com. The study participants provided informed consent for data sharing. No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Zhi Guo, Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Cancer Research Center, Key Laboratory of Cancer Prevention and Therapy, Tiyuan Beihuan West Road, Tianjin 300070, China. guoztj@126.com
Telephone: +86-22-23537796 Fax: +86-22-23537796
Received: February 17, 2017
Peer-review started: February 17, 2017
First decision: February 28, 2017
Revised: March 10, 2017
Accepted: March 17, 2017
Article in press: March 17, 2017
Published online: March 28, 2017
Processing time: 39 Days and 1.6 Hours
Abstract
AIM

The purpose of this study was to evaluate the diagnostic value of trefoil factor family 3 (TFF3) for the early detection of colorectal cancer (CC).

METHODS

Serum TFF3 and carcino-embryonic antigen (CEA) were detected in 527 individuals, including 115 healthy control (HC), 198 colorectal adenoma (CA), and 214 CC individuals in the training group.

RESULTS

Serum TFF3 showed no significant correlation with age, gender, or tumor location but showed significant correlation with the tumor stage. Serum TFF3 in the CC group was significantly higher than in the HC or CA group. The AUC values of TFF3 for discriminating between HC and CC and between CA and CC were 0.930 (0.903, 0.958) and 0.834 (0.796, 0.873). A multivariate model combining TFF3 and CEA was built. Compared to TFF3 or CEA alone, the multivariate model showed significant improvement (P < 0.001). For discriminating between HC and CC, HC and early stage CC, HC and advanced stage CC, CA and CC, CA and early stage CC, and CA and advanced stage CC in the training group, the sensitivities were 92.99%, 91.46%, 93.18%, 73.83%, 76.83%, and 81.82%, and the specificities were 91.30%, 91.30%, 93.91%, 88.38%, 77.27%, and 88.38%, respectively. After validation, the sensitivities were 89.39%, 85.71%, 90.79%, 72.73%, 71.43%, and 78.95%, and the specificities were 87.85%, 87.85%, 2.52%, 87.85%, 80.77%, and 87.50%, respectively.

CONCLUSION

The multivariate diagnostic model that included TFF3 and CEA showed significant improvement over the conventional biomarker CEA and might provide a potential method for the early detection of CC.

Keywords: Trefoil factor family 3; Colorectal cancer; Colorectal adenoma; Multivariate model; Diagnostic value

Core tip: Serum level of trefoil factor family 3 (TFF3) was used for evaluation the diagnostic value of for the early detection of colorectal cancer (CC). A multivariate model combining TFF3 and carcino-embryonic antigen (CEA) was built. Compared to TFF3 or CEA alone, the multivariate model showed significant improvement. The multivariate diagnostic model that included TFF3 and CEA showed significant improvement over the conventional biomarker CEA and might provide a potential method for the early detection of CC.