Evidence map›Paper›PMID 29872358›Full record

ArticleBiomarkers in cancer2018

Clean Colorectum at Diagnostic Colonoscopy: Subsequent Detection of Extracolonic Malignancies by Plasma Protein Biomarkers?

Michael Wilhelmsen, Ib J Christensen, Lars N Jørgensen, Mogens R Madsen, Jesper Vilandt, Thore Hillig, Michael Klærke, Knud T Nielsen, Søren Laurberg, Susan Gawel and 5 more

Abstract read
In one paragraph

Article in Biomarkers in cancer, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Michael WilhelmsenDepartment of Surgical Gastroenterology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark.
Ib J ChristensenDepartment of Surgical Gastroenterology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark.
Lars N JørgensenDepartment of Surgical Gastroenterology, Bispebjerg Hospital, Copenhagen, Denmark.
Mogens R MadsenDepartment of Surgery, Herning Hospital, Herning, Denmark.
Jesper VilandtDepartment of Surgery, Hillerød Hospital, Hillerød, Denmark.
Thore HilligDepartment of Clinical Biochemistry, Hillerød Hospital, Hillerød, Denmark.
Michael KlærkeDepartment of Surgery, Horsens Hospital, Horsens, Denmark.
Knud T NielsenDepartment of Surgery, Randers Hospital, Randers, Denmark.
Søren LaurbergDepartment of Surgical Gastroenterology, Aarhus Hospital THG, Aarhus, Denmark.
Susan GawelAbbott Cancer Core R&D, Abbott Diagnostics Division, Abbott Park, Chicago, IL, USA.
Xiaoping YangAbbott Cancer Core R&D, Abbott Diagnostics Division, Abbott Park, Chicago, IL, USA.
Gerard DavisAbbott Cancer Core R&D, Abbott Diagnostics Division, Abbott Park, Chicago, IL, USA.
Anne Meike HeijboerDepartment of Clinical Chemistry, VUMC, Amsterdam, The Netherlands.
Frans MartensDepartment of Clinical Chemistry, VUMC, Amsterdam, The Netherlands.
Hans J NielsenDepartment of Surgical Gastroenterology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMost of the subjects undergoing diagnostic colonoscopy do not have neoplastic bowel lesions. Potentially, some of the symptoms may therefore be caused by extracolonic malignancy, and subjects with persisting symptoms may need subsequent examinations. Blood-based, cancer-associated biomarkers may aid in directing the examinations for other specific malignant diseases.

methodsEDTA plasma samples available from a previous prospective study of subjects undergoing diagnostic colonoscopy were used for analysis of 18 protein biomarkers. The study population of 3732 subjects included 400 patients with colorectal cancer (CRC) and 177 patients with extracolonic malignancies. Univariable analysis of the association of specific biomarkers and extracolonic cancers included those with 10 or more cases. Subsequently, reduced models of 4 or 6 biomarkers, respectively, were established by choosing those with the highest likelihood; age and sex were included as well.

resultsUnivariable analyses showed that CyFra21-1 had an area under curve (AUC) of 0.87 for lung cancers (n = 33), CA19-9 had an AUC of 0.85 for pancreatic cancer (n = 22), CA125 had an AUC of 0.95 for ovary cancer (n = 16), B2M had an AUC of 0.81 for non-Hodgkin lymphoma (n = 12), and total prostate-specific antigen had an AUC of 0.99 for prostate cancer (n = 10). The multivariable analysis of 4 or 6 biomarkers plus age and sex as explanatory variables showed AUCs of 0.82 to 0.85 both for extracolonic cancers and CRC. The 4 biomarkers included in the model for detection of extracolonic cancers were CA125, hsCRP, CA19-9, and CyFra21-1; the 2 additional for the 6 biomarkers model were CEA and Galectin-3. Similarly, the 4 biomarkers included in the model for detection of CRC were CEA, CyFra21-1, Ferritin, and HE4; the two additional for the 6 biomarkers model were hsCRP and Pepsinogen 2.

conclusionsResults of this study indicate that it may be possible to detect subjects that have an increased risk of extracolonic cancer following a colonoscopy without findings of neoplastic lesions. Combinations of various protein biomarkers may direct subsequent examination after colonoscopy with clean colorectum. The results, although preliminary, may form the basis for additional research directed both for primary examinations of subjects with symptoms of malignancy and subsequent examinations after colonoscopy.

Indexed as

biomarkerscancerColon cancerendoscopyprotein biomarkers

Identifiers

PMID29872358
PMCPMC5977429

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.