PT  - JOURNAL ARTICLE
AU  - Rengucci, Claudia
AU  - De Maio, Giulia
AU  - Menghi, Maura
AU  - Scarpi, Emanuela
AU  - Guglielmo, Simona
AU  - Fusaroli, Pietro
AU  - Caletti, Giancarlo
AU  - Saragoni, Luca
AU  - Gardini, Andrea Casadei
AU  - Zoli, Wainer
AU  - Falcini, Fabio
AU  - Amadori, Dino
AU  - Calistri, Daniele
TI  - Improved Stool DNA Integrity Method for Early Colorectal Cancer Diagnosis
AID  - 10.1158/1055-9965.EPI-14-0379
DP  - 2014 Nov 01
TA  - Cancer Epidemiology Biomarkers & Prevention
PG  - 2553--2560
VI  - 23
IP  - 11
4099  - http://cebp.aacrjournals.org/content/23/11/2553.short
4100  - http://cebp.aacrjournals.org/content/23/11/2553.full
SO  - Cancer Epidemiol Biomarkers Prev2014 Nov 01; 23
AB  - Background: DNA integrity analysis could represent an alternative approach to the early detection of colorectal cancer. Previously, fluorescence long DNA (FL-DNA) in stools was extracted using a manual approach and analyzed by capillary electrophoresis assay (CE FL-DNA). We aimed to improve diagnostic accuracy using a simpler and more standardized method [Real Time PCR FL-DNA (RT FL-DNA)] for the detection of early malignant lesions in a population undergoing colorectal cancer screening. Methods: From 241 stool samples, DNA was extracted using manual and semiautomatic extraction systems and analyzed using FL-DNA tests by CE and RT assays. The RT FL-DNA approach showed slightly higher sensitivity and specificity compared with the CE FL-DNA method. Furthermore, we compared the RT FL-DNA approach with the iFOBT report. Results: Nonparametric ranking statistics were used to analyze the relationship between the median values of RT FL-DNA and the clinicohistopathologic characteristics. The median values of both variables were significantly higher in patients with cancer than in patients with noncancerous lesions. According to the Fagan nomogram results, the iFOBT and FL-DNA methods provided more accurate diagnostic information and were able to identify subgroups at varying risks of cancer. Conclusions: The combination of the semiautomatic extraction system and RT FL-DNA analysis improved the quality of DNA extracted from stool samples. Impact: RT FL-DNA shows great potential for colorectal cancer diagnosis as it is a reliable and relatively easy analysis to perform on routinely processed stool samples in combination with iFOBT. Cancer Epidemiol Biomarkers Prev; 23(11); 2553–60. ©2014 AACR.