Evaluation of nuclear matrix protein, fibronectin and neutrophil-to-lymphocyte ratio combined for colon cancer diagnosis increases sensitivity and specificity

© 2018 ISISnet: Innovative Scientific Information Services Network. All rights reserved. There is growing interest in colon cancer early detection as current screening methods lack compliance and specificity. No serum-based test is currently sufficient for widespread use. Here we demonstrate that combining nuclear (nuclear matrix protein, NMP), extracellular (fibronectin, FN) and blood (neutrophil-to-lymphocyte ratio, NLR) markers in an index would improve colon cancer diagnostic efficacy. One-hundred and twenty six individuals categorized into two groups (40 healthy individuals, 20 benign inflammatory bowel diseases and 66 colon cancer patients (Stage I–IV). NMP and FN were quantified by ELISA and NLRs were calculated from blood count. NMP-52, FN and NLR circulating levels were significantly (P<0.0001) elevated in colon cancer. These elevated levels were associated with disease aggressive behavior (advanced stages (III-IV), high tumor depth (T3-T4), high tumor grade (G3-G4), lymph node invasion (≥N1) and distant organ metastasis (M1)). Stepwise logistic regression analysis combining three markers in an index that has interesting diagnostic capability (AUC=0.934, sensitivity 100%, specificity 75%) which did not significantly changed in detection of early tumor stages. Index odds ratio (95%CI) was 6.8 (4.1-11.5) for colon cancer and 3.5 (2.2-5.6) for early stages. In conclusions, Combination of NMP, FN and NLR improve colon cancer diagnostic efficacy. Because the detection of these markers is easy assay and quick to perform, this index is a valuable clinical biomarker to recognize patients with a high risk to develop colon cancer.