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. 2017 Nov 30;8(11):e128.
doi: 10.1038/ctg.2017.53.

Blood-Based Protein Signatures for Early Detection of Colorectal Cancer: A Systematic Review

Megha Bhardwaj  1 , Anton Gies  1 , Simone Werner  2 , Petra Schrotz-King  1 , Hermann Brenner  1   2   3
Affiliations

Blood-Based Protein Signatures for Early Detection of Colorectal Cancer: A Systematic Review

Megha Bhardwaj et al. Clin Transl Gastroenterol. .

Abstract

Objectives: Blood-based proteins might be an attractive option for early detection of colorectal cancer (CRC), but individually they are unlikely to achieve the diagnostic performance required for population based screening. We aimed at summarizing current evidence of diagnostic performance of signatures based on multiple proteins for early detection of CRC.

Methods: A systematic literature review adhering to the PRISMA (preferred reporting items for systematic reviews and meta-analysis) guidelines was performed. PubMed and Web of Science databases were searched for potentially relevant studies published until 28th August, 2017. Relevant studies were identified by predefined eligibility criteria. Estimates of indicators of diagnostic performance such as sensitivity, specificity, and the area under the curve (AUC), along with information on validation and other key methodological procedures were extracted. Study quality was assessed by a QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies 2) instrument tool.

Results: Thirty six eligible studies with numbers of CRC cases ranging from 23 to 512 and the number of proteins included in signatures ranged from 3 to 13 were identified. Reported Youden's Index and AUC ranged from 0.19 to 0.95 and from 0.62 to 0.996, respectively. However most studies, especially those reporting better diagnostic performance, were conducted in clinical rather than screening setting and many studies lacked any internal or external validation of identified algorithm.

Conclusions: Blood-based tests using signatures of multiple proteins may be a promising approach for non-invasive CRC screening. However, promising signatures identified in clinical settings still require rigorous evaluation in large studies conducted in true screening setting.

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Conflict of interest statement

Guarantor of the article: Megha Bhardwaj.

Specific author contributions: Hermann Brenner designed and supervised the study. Megha Bhardwaj carried out the literature search and drafted the manuscript. Megha Bhardwaj and Anton Gies extracted the data from the eligible studies. All authors critically reviewed, contributed to and approved the final manuscript.

Financial support: None.

Potential competing interests: The German Cancer Research Center has received industrial grants related to blood markers for early detection of colorectal cancer from Epigenomics, Applied Proteomics, Roche Diagnostics, and Volition. Megha Bhardwaj had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Figures

Figure 1
Figure 1
PRISMA flow diagram for literature search process for records identified via PubMed and Web of Science database.
See this image and copyright information in PMC

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