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Emerging role of colorectal mucus in gastroenterology diagnostics

World Journal of Gastroenterology 2022年第12期28卷 1220-1225页

作者： Hesam Ahmadi Nooredinvand Andrew Poullis Department of Gastroenterology St George's HospitalLondon SW170QTUnited Kingdom

Colonoscopy is currently the gold standard for diagnosis of inflammatory bowel disease(IBD)and colorectal cancer(CRC).This has the obvious drawback of being invasive as well as carrying a small *** most widely used non-invasive approaches include the use of faecal calprotectin in the case of IBD and fecal immunochemical test in the case of ***,the necessity of stool collection limits their acceptability for some *** the recent years,there has been emerging data looking at the role of non-invasively obtained colorectal mucus as a screening and diagnostic tool in IBD and *** has been shown that the mucus rich material obtained by self-sampling of anal surface following defecation,can be used to measure various biomarkers that can aid in diagnosis of these conditions.

关键词： colorectal mucus Inflammatory bowel disease Crohn's disease Ulcerative colitis colorectal cancer Faecal calprotectin

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Biomarkers for detecting colorectal cancer non-invasively: DNA,RNA or proteins?

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World Journal of Gastrointestinal Oncology 2020年第2期12卷 124-148页

作者： Alexandre Loktionov Diag Nodus Ltd Babraham Research Campus

colorectal cancer(CRC)is a global problem affecting millions of people *** disease is unique because of its slow progress that makes it preventable and often *** symptoms usually emerge only at advanced stages of the disease,consequently its early detection can be achieved only through active population screening,which markedly reduces mortality due to this *** screening tests that employ non-invasively detectable biomarkers are currently being actively developed and,in most cases,samples of either stool or blood are ***,alternative biological substances that can be collected non-invasively(colorectal mucus,urine,saliva,exhaled air)have now emerged as new sources of diagnostic *** main categories of currently explored CRC biomarkers are:(1)Proteins(comprising widely used haemoglobin);(2)DNA(including mutations and methylation markers);(3)RNA(in particular microRNAs);(4)Low molecular weight metabolites(comprising volatile organic compounds)detectable by metabolomic techniques;and(5)Shifts in gut microbiome *** tests for early CRC detection employing such non-invasive biomarkers have been proposed and clinically *** some of these studies generated promising early results,very few of the proposed tests have been transformed into clinically validated diagnostic/screening *** DNA-based tests as Food and Drug Administration-approved multitarget stool test(marketed as Cologuard®)or blood test for methylated septin 9(marketed as Epi proColon®2.0 CE)show good diagnostic performance but remain too expensive and technically complex to become effective CRC screening *** can be concluded that,despite its deficiencies,the protein(haemoglobin)detection-based faecal immunochemical test(FIT)today presents the most cost-effective option for non-invasive CRC *** combination of non-invasive FIT and confirmatory invasive colonoscopy is the current strategy of choice for CRC ***

关键词： colorectal cancer screening Biomarkers Non-invasive testing Stool colorectal mucus Blood

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