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THE USEFULNESS OF FUSOBACTERIUM NUCLEATUM MEASUREMENT IN STOOL FOR COLORECTAL CANCER SCREENING

Takuma Higurashi 1, Shigeki Tamura 1, Noboru Misawa 1, Tsutomu Yoshihara 1, Tetsuya Matsuura 1, Atsushi Nakajima 1

Affiliations

1 Yokohama City University, Yokohama, Japan

Summary

AI Generated

A study of 41 colorectal cancer patients and 41 healthy controls found that combining fecal occult blood testing with ELISA measurement of antibodies against Fusobacterium nucleatum improved sensitivity from 61 percent to 73-90 percent depending on cut-off values.

ELISA measurement of antibodies against FadA expressed by Fusobacterium nucleatum correlated well with PCR quantification (r=0.722, p<0.001) and offers a simpler alternative to PCR for colorectal cancer screening.
Combining FOBT with Fusobacterium nucleatum ELISA achieved sensitivity of 90 percent and specificity of 78 percent at cut-off #1, or sensitivity of 73 percent and specificity of 93 percent at cut-off #2, compared to 61 percent sensitivity for FOBT alone.
For advanced cancer stage II or higher, combined testing achieved 100 percent sensitivity at cut-off #1 and 79 percent at cut-off #2, while early cancer detection was 76 percent and 59 percent respectively.
The authors note challenges in setting appropriate cut-off values for screening use and plan to evaluate effectiveness in populations with low screening participation rates.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

Over the world, fecal occult blood testing (FOBT) is used as a colorectal cancer (CRC) screening method for middle age and older age, but there are problems such as sensitivity/specificity issues, low participation rates in primary and secondary screenings, and that the incidence/mortality rates of CRC are still high. Fusobacterium nucleatum (Fn) has been reported to be frequently detected in the feces of CRC patients in recent years, and it has been reported that screening sensitivity can be increased by combining it with Fn PCR testing. However, due to the cost and technical complexity of PCR, it has not yet been widely used in clinical practice. In this study, we developed a simple method using ELISA to measure antibodies against FadA expressed by Fn and evaluated its usefulness.

Aims & Methods

We evaluated FOBT, Fn PCR quantification, and Fn (ELISA) in 41 individuals diagnosed with CRC from April 2020 to December 2022 and 41 healthy volunteers without CRC. Subgroup analysis was also performed in CRC patients at each stage.

Results

The correlation coefficient between Fn PCR quantification and Fn (ELISA) was good at r=0.722, p<0.001. FOBT alone had a sensitivity of 61% and a specificity of 100%. In Fn ELISA, when cut off#1 was set to maximize the AUC in ROC, the sensitivity and specificity were 76% and 78%, respectively, and when combined with FOBT, the sensitivity was 90% and the specificity was 78%. In screening, high specificity is required, so we set cut off#2 Fn ELISA to achieve a specificity of 93% and performed analysis. When combined with FOBT, the sensitivity was 73% and the specificity was 93%. When targeting advanced cancer of stage II or higher, the sensitivity by combining FOBT and Fn ELISA was 100% at cut off#1 and 79% at cut off#2, while for early cancer, the sensitivity was 76% at cut off#1 and 59% at cut off#2, both of which were better than the sensitivity of FOBT alone.

Conclusion

By combining Fn measurement using ELISA with FOBT, it was possible to increase the diagnostic sensitivity and reduce false negatives compared to FOBT alone. There are challenges such as setting appropriate cut-off values for use in screening, but measuring Fn in addition to FOBT may improve screening accuracy and increase the participation rate in secondary screening, and in the future, we would like to evaluate its effectiveness even in populations with low prior probability of screening participation.

Conference

UEG Week Copenhagen 2023

Topics

Colorectal

Submission format

Abstract

Session

PP 06 Other lower GI disorders (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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Panel discussion: Screening for colorectal cancer

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