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Quantitation of faecal Fusobacterium improves faecal immunochemical test in detecting advanced colorectal neoplasia
Open accessAbstract
Objective There is a need for an improved biomarker for colorectal cancer (CRC) and advanced adenoma. We evaluated faecal microbial markers for clinical use in detecting CRC and advanced adenoma. Design We measured relative abundance of Fusobacterium nucleatum (Fn), Peptostreptococcus anaerobius (Pa) and Parvimonas micra (Pm) by quantitative PCR in 309 subjects, including 104 patients with CRC, 103 patients with advanced adenoma and 102 controls. We evaluated the diagnostic performance of these biomarkers with respect to faecal immunochemical test (FIT), and validated the results in an independent cohort of 181 subjects. Results The abundance was higher for all three individual markers in patients with CRC than controls (p<0.001), and for marker Fn in patients with advanced adenoma than controls (p=0.022). The marker Fn, when combined with FIT, showed superior sensitivity (92.3% vs 73.1%, p<0.001) and area under the receiver-operating characteristic curve (AUC) (0.95 vs 0.86, p<0.001) than stand-alone FIT in detecting CRC in the same patient cohort. This combined test also increased the sensitivity (38.6% vs 15.5%, p<0.001) and AUC (0.65 vs 0.57, p=0.007) for detecting advanced adenoma. The performance gain for both CRC and advanced adenoma was confirmed in the validation cohort (p=0.0014 and p=0.031, respectively). Conclusions This study identified marker Fn as a valuable marker to improve diagnostic performance of FIT, providing a complementary role to detect lesions missed by FIT alone. This simple approach may improve the clinical utility of the current FIT, and takes one step further towards a non-invasive, potentially more accurate and affordable diagnosis of advanced colorectal neoplasia.
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“Combining the fecal microbiome data with scores from risk factor-based models or results of screening tests (such as fecal occult blood test and fecal immunochemical test) increases the accuracy of detection for advanced adenomas.35, 186, 187”
From Influence of the Gut Microbiome, Diet, and Environment on Risk of Colorectal Cancer (2020) · cites this paper as [186]
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Metadata
- Authors
- Wong, S. H., Kwong, T. N. Y., Chow, T.-C., Luk, A. K. C., Dai, R. Z. W., Nakatsu, G., Lam, T. Y. T., Zhang, L., Wu, J. C. Y., Chan, F. K. L., Ng, S. S. M., Wong, M. C. S., Ng, S. C., Wu, W. K. K., Yu, J., & Sung, J. J. Y.
- Affiliations
- Chinese University of Hong Kong (HK)
- Corresponding author
- Sung, Joseph J Y
- ORCID
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2016-10-24
- Volume
- 66
- Issue
- 8
- Pages
- 1441-1448
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC5530471
- OpenAlex
- W2537258608
- Cited by
- 310
- References
- 32
- Citations by year
- 2026: 28 · 2025: 32 · 2024: 41 · 2023: 40 · 2022: 40 · 2021: 36 · 2020: 34 · 2019: 22 · 2018: 24 · 2017: 13
- FWCI
- 10.61
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Gut (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Croucher Foundation
- Shenzhen Virtual University Park
- National Key Research and Development Program of China (2013CB531401)
- Topics
- Health Sciences › Medicine › Oncology › Colorectal Cancer Screening and Detection
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Pathology and Forensic Medicine › Genetic factors in colorectal cancer
- Keywords
- Fusobacterium nucleatum, Peptostreptococcus anaerobius, Parvimonas micra, fecal immunochemical test, colorectal cancer, advanced adenoma, colorectal neoplasia detection, diagnostic sensitivity, non-invasive diagnosis
- MeSH terms
- Adenocarcinoma, Adenoma, DNA, Bacterial, Feces, Female, Humans, Male, Middle Aged, Occult Blood, Peptostreptococcus, ROC Curve, Biomarkers, Tumor, Colorectal Neoplasms, Fusobacterium nucleatum, Area Under Curve
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