Urinary N1, N12-diacetylspermine as a potential tumor biomarker for gastric and colorectal cancer

doi:10.3748/wjg.118185

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 32, Issue 33

This Article

(0)

Peer-Review Report of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Journal Information of This Article

Publication Name

World Journal of Gastroenterology

ISSN

1007-9327

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

- Full Article (XML)

Observational Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Sep 7, 2026; 32(33): 118185
Published online Sep 7, 2026. doi: 10.3748/wjg.118185

Urinary N1, N12-diacetylspermine as a potential tumor biomarker for gastric and colorectal cancer

Hua-Zhen Zheng, Peng Wang, Hui-Jie Zheng, Zi-Qi Wang, Qi-Xin Li, Huan-Wei Chen, Huo-Qiang Chen, Qiu-Cheng Lei

Hua-Zhen Zheng, Hui-Jie Zheng, Zi-Qi Wang, Qi-Xin Li, Huo-Qiang Chen, Department of Laboratory Medicine, The First People’s Hospital of Foshan (Foshan Hospital Affiliated to Southern University of Science and Technology), School of Medicine, Southern University of Science and Technology, Foshan 528000, Guangdong Province, China

Peng Wang, Department of Gastrointestinal Surgery, The First People’s Hospital of Foshan (Foshan Hospital Affiliated to Southern University of Science and Technology), School of Medicine, Southern University of Science and Technology, Foshan 528000, Guangdong Province, China

Huan-Wei Chen, Qiu-Cheng Lei, Department of Hepatobiliary and Pancreatic Surgery, The First People’s Hospital of Foshan (Foshan Hospital Affiliated to Southern University of Science and Technology), School of Medicine, Southern University of Science and Technology, Foshan 528000, Guangdong Province, China

Co-first authors: Hua-Zhen Zheng and Peng Wang.

Co-corresponding authors: Huo-Qiang Chen and Qiu-Cheng Lei.

Author contributions: Zheng HZ and Wang P contributed equally to data collection, statistical analysis, and original draft preparation, they contributed equally to this article and are the co-first authors of this manuscript; Zheng HZ, Wang ZQ, and Zheng HJ performed sample testing; Li QX and Chen HW conducted participant recruitment; Zheng HZ, Wang P, and Lei QC acquired funding and oversaw all stages of the project; Zheng HZ, Wang P, Zheng HJ, and Wang ZQ contributed to patient follow-up; Chen HQ and Lei QC jointly supervised experimental design, writing, review, and editing, they are the co-corresponding authors of this manuscript; and all authors thoroughly reviewed and endorsed the final manuscript.

Supported by National Natural Science Foundation of China (General Program), No. 82400651; and the Foshan Science and Technology Innovation Project, No. 2320001006781.

Institutional review board statement: This study was approved by the Medical Ethics Committee of Foshan First People’s Hospital, approval No. Medical ethics 2016 No. 3.

Informed consent statement: All participants provided written informed consent for both participation in the study and publication of the data.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: The raw data that support the findings of this study are available from the corresponding author upon reasonable request.

Corresponding author: Qiu-Cheng Lei, MM, Attending Physician, Department of Hepatobiliary and Pancreatic Surgery, The First People’s Hospital of Foshan (Foshan Hospital Affiliated to Southern University of Science and Technology), School of Medicine, Southern University of Science and Technology, No. 81 Lingnan Avenue North, Foshan 528000, Guangdong Province, China. lqiuchenggd@163.com

Received: December 29, 2025
Revised: February 25, 2026
Accepted: April 10, 2026
Published online: September 7, 2026
Processing time: 225 Days and 7.2 Hours

Abstract

BACKGROUND

Previous studies have reported elevated urinary N1, N12-diacetylspermine (DiAcSpm) levels in various cancers. We therefore hypothesized that urinary DiAcSpm could serve as a potential biomarker for gastric and colorectal cancers (CRCs) and may also have prognostic value.

AIM

To assess the diagnostic potential of urinary DiAcSpm for gastric and CRC and to explore its prognostic significance.

METHODS

A total of 209 urine samples were collected from patients with gastrointestinal cancers, benign gastrointestinal diseases, and healthy controls. Pre- and post-treatment clinical data were obtained for all participants. Urinary DiAcSpm levels were measured using a commercially available reagent kit via an immunoturbidimetric assay on an automated biochemical analyzer.

RESULTS

Urinary DiAcSpm concentrations were significantly higher in patients with gastric and CRCs compared with benign disease patients and healthy controls. It discriminated gastric cancer (GC) from healthy controls with an area under the curve (AUC) of 0.714 [95% confidence interval (CI): 0.613-0.815], sensitivity of 59.65%, and specificity of 76.19%. For CRC, the AUC was 0.736 (95%CI: 0.648-0.824), with sensitivity of 42.11% and specificity of 95.24%. Combining DiAcSpm with carcinoembryonic antigen improved diagnostic performance [GC: AUC = 0.755 (95%CI: 0.657-0.852), sensitivity = 94.74%, specificity = 50.00%; CRC: AUC = 0.813 (95%CI: 0.739-0.887), sensitivity = 91.23%, specificity = 58.73%]. Urinary DiAcSpm levels significantly decreased after chemotherapy in CRC patients. High DiAcSpm levels were associated with distant metastasis in GC patients.

CONCLUSION

Urinary DiAcSpm levels are markedly elevated in patients with GC and CRC. While its standalone diagnostic accuracy requires further improvement, DiAcSpm shows promise as a complementary marker to existing serum biomarkers in combined diagnostic strategies.

Keywords: N1, N12-diacetylspermine; Tumor biomarker; Gastric cancer; Colorectal cancer; Urinary N1, N12-diacetylspermine; Liquid biopsy

Core Tip: Urinary N1, N12-diacetylspermine (DiAcSpm) was evaluated as a potential non-invasive biomarker for gastric and colorectal cancer. Levels were significantly elevated in cancer patients and showed moderate diagnostic value, which improved when combined with carcinoembryonic antigen. Urinary DiAcSpm levels decreased after chemotherapy in colorectal cancer patients, and high levels correlated with distant metastasis in gastric cancer patients. These findings support the potential of urinary DiAcSpm, though prospective studies in larger cohorts are warranted to confirm its clinical utility.