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He SY, Li YC, Wang Y, Peng HL, Zhou CL, Zhang CM, Chen SL, Yin JF, Lin M. Fecal gene detection based on next generation sequencing for colorectal cancer diagnosis. World J Gastroenterol 2022; 28:2920-2936. [PMID: 35978873 PMCID: PMC9280739 DOI: 10.3748/wjg.v28.i25.2920] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 03/18/2022] [Accepted: 05/28/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is one of the most common malignancies worldwide. Given its insidious onset, the condition often already progresses to advanced stage when symptoms occur. Thus, early diagnosis is of great significance for timely clinical intervention, efficacy enhancement, and prognostic improvement. Featuring high throughput, fastness, and rich information, next generation sequencing (NGS) can greatly shorten the detection time, which is a widely used detection technique at present.
AIM To screen specific genes or gene combinations in fecal DNA that are suitable for diagnosis and prognostic prediction of CRC, and to establish a technological platform for CRC screening, diagnosis, and efficacy monitoring through fecal DNA detection.
METHODS NGS was used to sequence the stool DNA of patients with CRC, which were then compared with the genetic testing results of the stool samples of normal controls and patients with benign intestinal disease, as well as the tumor tissues of CRC patients. Specific genes or gene combinations in fecal DNA suitable for diagnosis and prognostic prediction of CRC were screened, and their significances in diagnosing CRC and predicting patients' prognosis were comprehensively evaluated.
RESULTS High mutation frequencies of TP53, APC, and KRAS were detected in the stools and tumor tissues of CRC patients prior to surgery. Contrastively, no pathogenic mutations of the above three genes were noted in the postoperative stools, the normal controls, or the benign intestinal disease group. This indicates that tumor-specific DNA was detectable in the preoperative stools of CRC patients. The preoperative fecal expression of tumor-associated genes can reflect the gene mutations in tumor tissues to some extent. Compared to the postoperative stools and the stools in the two control groups, the pathogenic mutation frequencies of TP53 and KRAS were significantly higher for the preoperative stools (χ2 = 7.328, P < 0.05; χ2 = 4.219, P < 0.05), suggesting that fecal TP53 and KRAS genes can be used for CRC screening, diagnosis, and prognostic prediction. No significant difference in the pathogenic mutation frequency of the APC gene was found from the postoperative stools or the two control groups (χ2 = 0.878, P > 0.05), so further analysis with larger sample size is required. Among CRC patients, the pathogenic mutation sites of TP53 occurred in 16 of 27 preoperative stools, with a true positive rate of 59.26%, while the pathogenic mutation sites of KRAS occurred in 10 stools, with a true positive rate of 37.04%. The sensitivity and negative predictive values of the combined genetic testing of TP53 and KRAS were 66.67% (18/27) and 68.97%, respectively, both of which were higher than those of TP53 or KRAS mutation detection alone, suggesting that the combined genetic testing can improve the CRC detection rate. The mutation sites TP53 exon 4 A84G and EGFR exon 20 I821T (mutation start and stop positions were both 7579436 for the former, while 55249164 for the latter) were found in the preoperative stools and tumor tissues. These "undetected" mutation sites may be new types of mutations occurring during the CRC carcinogenesis and progression, which needs to be confirmed through further research. Some mutations of "unknown clinical significance" were found in such genes as TP53, PTEN, KRAS, BRAF, AKT1, and PIK3CA, whose clinical values is worthy of further exploration.
CONCLUSION NGS-based fecal genetic testing can be used as a complementary technique for the CRC diagnosis. Fecal TP53 and KRAS can be used as specific genes for the screening, diagnosis, prognostic prediction, and recurrence monitoring of CRC. Moreover, the combined testing of TP53 and KRAS genes can improve the CRC detection rate.
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Affiliation(s)
- Si-Yu He
- Department of Clinical Laboratory, Taizhou People's Hospital (Postgraduate Training Base of Dalian Medical University), Taizhou 225300, Jiangsu Province, China
- Department of Clinical Laboratory, The First People's Hospital of Tianmen City, Tianmen 431700, Hubei Province, China
| | - Ying-Chun Li
- Department of General Surgery, Taizhou People's Hospital (Postgraduate Training Base of Dalian Medical University), Taizhou 225300, Jiangsu Province, China
| | - Yong Wang
- Department of General Surgery, Taizhou People's Hospital (Postgraduate Training Base of Dalian Medical University), Taizhou 225300, Jiangsu Province, China
| | - Hai-Lin Peng
- Department of Clinical Laboratory, Taizhou People's Hospital (Postgraduate Training Base of Dalian Medical University), Taizhou 225300, Jiangsu Province, China
| | - Cheng-Lin Zhou
- Department of Clinical Laboratory, Taizhou People's Hospital (Postgraduate Training Base of Dalian Medical University), Taizhou 225300, Jiangsu Province, China
| | - Chuan-Meng Zhang
- Central Laboratory, Taizhou People's Hospital (Postgraduate training base of Dalian Medical University), Taizhou 225300, Jiangsu Province, China
| | - Sheng-Lan Chen
- Department of Laboratory, Taizhou Genewill Medical Laboratory Company Limited, Taizhou 225300, Jiangsu Province, China
| | - Jian-Feng Yin
- Department of Laboratory, Jiangsu CoWin Biotech Co., Ltd., Taizhou 225300, Jiangsu Province, China
| | - Mei Lin
- Department of Clinical Laboratory, Taizhou People's Hospital (Postgraduate Training Base of Dalian Medical University), Taizhou 225300, Jiangsu Province, China
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Liu M, Sun Y, Tang L, Hu C, Sun B, Huang Z, Chen L. Fingerprinting fecal DNA and mRNA as a non-invasive strategy to assess the impact of polychlorinated biphenyl 126 exposure on zebrafish. J Environ Sci (China) 2021; 106:15-25. [PMID: 34210431 DOI: 10.1016/j.jes.2021.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/13/2021] [Accepted: 01/13/2021] [Indexed: 06/13/2023]
Abstract
In toxicological studies, experimental animals are generally subjected to dissection to obtain the tissues of concern, which causes great harm to the animals. In this regard, it is necessary to test and develop a non-invasive strategy to prevent the animals from anthropic injury when achieving scientific objectives. Therefore, zebrafish fecal DNA and mRNA pools were assessed by using metagenomic and transcriptomic analyses based on their potential to diagnose toxicological impairment of polychlorinated biphenyl (PCB) 126, a model persistent organic pollutant. The results showed that there was abundant zebrafish DNA and mRNA in the feces, which were, however, associated with contrasting profiles of physiological activities. As compared to DNA fragments, fecal mRNA provided a better representation of zebrafish physiological status. PCB126 exposure dramatically shifted the composition of fecal zebrafish DNA and mRNA as a function of sex. The differential mRNA caused by PCB126 clearly identified the toxicological fingerprint of PCB126. In summary, this study provides preliminary clues about the potential of fecal genes (mRNA in particular) in the development of non-invasive toxicological approaches. In the future, it is expected that more works will be conducted to screen sensitive diagnostic biomarkers from feces to increase the rate and reduce the cost of ecological risk assessment.
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Affiliation(s)
- Mengyuan Liu
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yumiao Sun
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Lizhu Tang
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Chenyan Hu
- School of Chemistry and Environmental Engineering, Wuhan Institute of Technology, Wuhan 430072, China
| | - Baili Sun
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China; University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zileng Huang
- School of Chemistry and Environmental Engineering, Wuhan Institute of Technology, Wuhan 430072, China
| | - Lianguo Chen
- State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan 430072, China.
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Qin Y, Taylor W, Bamlet WR, Ravindran A, Buglioni A, Cao X, Foote PH, Slettedahl SW, Mahoney DW, Albert PS, Kim S, Hu N, Taylor PR, Etemadi A, Sotoudeh M, Malekzadeh R, Abnet CC, Smyrk TC, Katzka D, Topazian MD, Dawsey SM, Ahlquist D, Kisiel JB, Iyer PG. Methylated DNA Markers of Esophageal Squamous Cancer and Dysplasia: An International Study. Cancer Epidemiol Biomarkers Prev 2020; 29:2642-2650. [PMID: 32948633 DOI: 10.1158/1055-9965.epi-20-0616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/22/2020] [Accepted: 09/11/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Discovery of methylated DNA markers (MDM) of esophageal squamous cell carcinoma (ESCC) has sparked interest in assessing these markers in tissue. We evaluated MDMs in ESCC from three geographically and ethnically distinct populations, and explored the feasibility of assaying MDMs from DNA obtained by swallowed balloon devices. METHODS MDMs were assayed in ESCC and normal tissues obtained from the populations of United States, Iran, and China, and from exfoliative cytology specimens obtained by balloons in a Chinese population. Areas under the receiver operating curve (AUC) of MDMs discriminating ESCC from normal tissues were calculated. Random forest prediction models were built, trained on U.S. cases and controls, and calibrated to U.S.-only controls (model 1) and three-country controls (model 2). Statistical tests were used to assess the relationship between dysplasia and MDM levels in balloons. RESULTS Extracted DNA from 333 ESCC and 322 normal tissues was analyzed, in addition to archival DNA from 98 balloons. For ESCC, model 1 validated in Iranian and Chinese tissues with AUCs of 0.90 and 0.87, and model 2 yielded AUCs of 0.99, 0.96, and 0.94 in tissues from the United States, Iran, and China, respectively. In Chinese balloons, MDMs showed a statistically significant trend of increasing levels with increasing grades of dysplasia (P < 0.004). CONCLUSIONS MDMs accurately discriminate ESCC from normal esophagus in tissues obtained from high- and low-incidence countries. Preliminary data suggest that levels of MDMs assayed in DNA from swallowed balloon devices increase with dysplasia grade. Larger studies are needed to validate these results. IMPACT MDMs coupled with minimally invasive collection methods have the potential for worldwide application in ESCC screening.
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Affiliation(s)
- Yi Qin
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - William Taylor
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - William R Bamlet
- Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - Adharsh Ravindran
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Alessia Buglioni
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Xiaoming Cao
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Patrick H Foote
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Seth W Slettedahl
- Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - Douglas W Mahoney
- Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | | | - Sungduk Kim
- Biostatistics Branch, NCI, Rockville, Maryland
| | - Nan Hu
- Metabolic Epidemiology Branch, NCI, Rockville, Maryland
| | | | - Arash Etemadi
- Metabolic Epidemiology Branch, NCI, Rockville, Maryland.,Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Sotoudeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Thomas C Smyrk
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - David Katzka
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Mark D Topazian
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | | | - David Ahlquist
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - John B Kisiel
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Prasad G Iyer
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
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Abstract
Fecal (or stool) DNA examination is a noninvasive strategy recommended by several medical professional societies for colorectal cancer (CRC) screening in average-risk individuals. Fecal DNA tests assay stool for human DNA shed principally from the colon. Colonic lesions such as adenomatous and serrated polyps and cancers exfoliate cells containing neoplastically altered DNA that may be detected by sensitive assays that target specific genetic and epigenetic biomarkers to discriminate neoplastic lesions from non-neoplastic tissue. Cross-sectional validation studies confirmed initial case-control studies' assessment of performance of an optimized multitarget stool DNA (mt-sDNA) test, leading to approval by the US Food and Drug Administration in 2014. Compared to colonoscopy, mt-sDNA showed sensitivity of 92% for detection of CRC, much higher than the 74% sensitivity of another recommended noninvasive strategy, fecal immunochemical testing (FIT). Detections of advanced adenomas and sessile serrated polyps were higher with mt-sDNA than FIT (42% versus 24% and 42% versus 5%, respectively), but overall specificity for all lesions was lower (87% versus 95%). The mt-sDNA test increases patient life-years gained in CRC screening simulations, but its cost relative to other screening strategies needs to be reduced by 80-90% or its sensitivity for polyp detection enhanced to be cost effective. Noninvasive CRC screening strategies such as fecal DNA, however, have the potential to significantly increase national screening rates due to their noninvasive nature and convenience for patients.
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Affiliation(s)
- John M Carethers
- Division of Gastroenterology and Hepatology, Department of Internal Medicine and Department of Human Genetics and Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan 48109, USA;
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Shi P, Sun J, He B, Song H, Li Z, Kong W, Wang J, Wang J, Xue H. Profiles of differentially expressed circRNAs in esophageal and breast cancer. Cancer Manag Res 2018; 10:2207-2221. [PMID: 30087579 PMCID: PMC6061203 DOI: 10.2147/cmar.s167863] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Introduction Circular RNAs (circRNAs) function as efficient microRNA sponges with gene-regulatory potential and are promising cancer biomarkers. In this study, we used the Arraystar Human circRNA Array to construct a genome-wide circRNA profile of esophageal squamous cell cancer (ESCC) and breast cancer (BC). Patients and methods Expression levels between cancer lesions and adjacent normal-appearing tissues were compared. We observed 469 upregulated circRNAs and 275 downregulated circRNAs in ESCC. Hsa_circRNA_103670 was upregulated 20.3-fold, while hsa_circRNA_030162 was downregulated 12.1-fold. For BC, 715 circRNAs were upregulated, and 440 circRNAs were downregulated. Hsa_circRNA_005230 was upregulated 12.2-fold, while hsa_circRNA_406225 was downregulated 12.4-fold. Results When we set the criteria as fold change in expression ≥2 between cancer and adjacent normal-appearing tissue with a P-value <0.01, there were 22 common circRNAs (11 upregulated and 11 downregulated) in relation to both ESCC and BC. Gene ontology and the Kyoto encyclopedia of genes and genomes analyses showed that these circRNAs were involved in the tumorigenesis of human cancers. Conclusion Our study revealed that circRNAs are promising candidates as valuable biomarkers for ESCC and BC, although relevant research is still in its infancy and the functional role of specific circRNAs in tumorigenesis is just starting to be elucidated.
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Affiliation(s)
- Peiyi Shi
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China,
| | - Jian Sun
- Department of Thoracic Surgery, The First People's Hospital of Yancheng City, Yancheng, People's Republic of China
| | - Biyu He
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China,
| | - Huan Song
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China,
| | - Zhongqi Li
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China,
| | - Weimin Kong
- Department of Thoracic Surgery, The First People's Hospital of Yancheng City, Yancheng, People's Republic of China
| | - Jianping Wang
- Department of Thoracic Surgery, People's Hospital of Yangzhong, Yangzhong, People's Republic of China,
| | - Jianming Wang
- Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China,
| | - Hengchuan Xue
- Department of Thoracic Surgery, People's Hospital of Yangzhong, Yangzhong, People's Republic of China,
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Rubin G, Walter F, Emery J, de Wit N. Reimagining the diagnostic pathway for gastrointestinal cancer. Nat Rev Gastroenterol Hepatol 2018; 15:181-188. [PMID: 29410534 DOI: 10.1038/nrgastro.2018.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A crisis is looming for the diagnosis of gastrointestinal cancers, one grounded only partly in the steady increase in their overall incidence. Public demand for diagnostic tests to be undertaken early and at lower levels of risk is reflected in early diagnosis being a widely held policy objective for reasons of both clinical outcome and patient experience. In the UK, urgent referrals for suspected lower gastrointestinal cancer have increased by 78% in the past 6 years, with parallel increases in endoscopy and imaging activity. Such growth in demand is unsustainable with current models of care. If gastrointestinal cancer diagnosis is to be affordable, the roles of professionals and their interactions with each other will need to be reframed while retaining public confidence in the process. In this Perspective, we consider how the relationship between medical specialists and generalists could be redefined to make better use of the skills of each while delivering optimal clinical outcomes and a good patient experience.
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Affiliation(s)
- Greg Rubin
- Institute of Health and Society, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK
| | - Fiona Walter
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - Jon Emery
- Centre for Cancer Research and Department of General Practice, University of Melbourne, Victoria Comprehensive Cancer Centre, 305 Grattan Street, Melbourne, Victoria 3010, Australia
| | - Niek de Wit
- Julius Center for Health Sciences and Primary Care University Medical Center, Utrecht, Netherlands
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Panebianco C, Kelman E, Vene K, Gioffreda D, Tavano F, Vilu R, Terracciano F, Pata I, Adamberg K, Andriulli A, Pazienza V. Cancer sniffer dogs: how can we translate this peculiarity in laboratory medicine? Results of a pilot study on gastrointestinal cancers. Clin Chem Lab Med 2017; 56:138-146. [PMID: 28590915 DOI: 10.1515/cclm-2016-1158] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 04/16/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Identification of cancer biomarkers to allow early diagnosis is an urgent need for many types of tumors, whose prognosis strongly depends on the stage of the disease. Canine olfactory testing for detecting cancer is an emerging field of investigation. As an alternative, here we propose to use GC-Olfactometry (GC/O), which enables the speeding up of targeted biomarker identification and analysis. A pilot study was conducted in order to determine odor-active compounds in urine that discriminate patients with gastrointestinal cancers from control samples (healthy people). METHODS Headspace solid phase microextraction (HS-SPME)-GC/MS and GC-olfactometry (GC/O) analysis were performed on urine samples obtained from gastrointestinal cancer patients and healthy controls. RESULTS In total, 91 key odor-active compounds were found in the urine samples. Although no odor-active biomarkers present were found in cancer carrier's urine, significant differences were discovered in the odor activities of 11 compounds in the urine of healthy and diseased people. Seven of above mentioned compounds were identified: thiophene, 2-methoxythiophene, dimethyl disulphide, 3-methyl-2-pentanone, 4-(or 5-)methyl-3-hexanone, 4-ethyl guaiacol and phenylacetic acid. The other four compounds remained unknown. CONCLUSIONS GC/O has a big potential to identify compounds not detectable using untargeted GC/MS approach. This paves the way for further research aimed at improving and validating the performance of this technique so that the identified cancer-associated compounds may be introduced as biomarkers in clinical practice to support early cancer diagnosis.
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Lin T, Liu T, Lin Y, Zhang C, Yan L, Chen Z, He Z, Wang J. Serum levels of chemical elements in esophageal squamous cell carcinoma in Anyang, China: a case-control study based on machine learning methods. BMJ Open 2017; 7:e015443. [PMID: 28947442 PMCID: PMC5623487 DOI: 10.1136/bmjopen-2016-015443] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Esophageal squamous cell carcinoma (ESCC) is the predominant form of esophageal carcinoma with extremely aggressive nature and low survival rate. The risk factors for ESCC in the high-incidence areas of China remain unclear. We used machine learning methods to investigate whether there was an association between the alterations of serum levels of certain chemical elements and ESCC. SETTINGS Primary healthcare unit in Anyang city, Henan Province of China. PARTICIPANTS 100 patients with ESCC and 100 healthy controls matched for age, sex and region were included. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome was the classification accuracy. Secondary outcome was the p Value of the t-test or rank-sum test. METHODS Both traditional statistical methods of t-test and rank-sum test and fashionable machine learning approaches were employed. RESULTS Random Forest achieves the best accuracy of 98.38% on the original feature vectors (without dimensionality reduction), and support vector machine outperforms other classifiers by yielding accuracy of 96.56% on embedding spaces (with dimensionality reduction). All six classifiers can achieve accuracies more than 90% based on the single most important element Sr. The other two elements with distinctive difference are S and P, providing accuracies around 80%. More than half of chemical elements were found to be significantly different between patients with ESCC and the controls. CONCLUSIONS These results suggest clear differences between patients with ESCC and controls, implying some potential promising applications in diagnosis, prognosis, pharmacy and nutrition of ESCC. However, the results should be interpreted with caution due to the retrospective design nature, limited sample size and the lack of several potential confounding factors (including obesity, nutritional status, and fruit and vegetable consumption and potential regional carcinogen contacts).
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Affiliation(s)
- Tong Lin
- The Key Laboratory of Machine Perception (Ministry of Education), School of EECS, Peking University, Beijing, China
| | - Tiebing Liu
- Civil Aviation Medicine Center, Civil Aviation Administration of China, Beijing, China
| | - Yucheng Lin
- The Key Laboratory of Machine Perception (Ministry of Education), School of EECS, Peking University, Beijing, China
| | - Chaoting Zhang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing, China
| | - Lailai Yan
- Center of Medical & Health Analysis, School of Public Health, Peking University, Beijing, China
| | - Zhongxue Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, Indiana, USA
| | - Zhonghu He
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing, China
| | - Jingyu Wang
- Center of Medical & Health Analysis, School of Public Health, Peking University, Beijing, China
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Abstract
OBJECTIVE To present an overview of current practices in the screening and early detection of gastrointestinal cancers. DATA SOURCES Literature reviews. CONCLUSION Screening for gastrointestinal cancers is less than desirable, particularly in underserved populations. There are inadequate methods of screening for early detection of esophageal and gastric cancers. IMPLICATIONS FOR NURSING PRACTICE Education of patients is needed to reinforce the importance of screening for gastrointestinal cancers.
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