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. 2022 Sep 20;14(19):4563.
doi: 10.3390/cancers14194563.

Evaluation of Blood Soluble CD26 as a Complementary Biomarker for Colorectal Cancer Screening Programs

Loretta De Chiara  1   2   3 , Leticia Barcia-Castro  1 , María Gallardo-Gómez  1 , María Páez de la Cadena  1 , Vicenta S Martínez-Zorzano  1 , Francisco J Rodríguez-Berrocal  1 , Luis Bujanda  4 , Ane Etxart  5 , Antoni Castells  6 , Francesc Balaguer  6 , Rodrigo Jover  7 , Joaquín Cubiella  8 , Oscar J Cordero  9
Affiliations

Evaluation of Blood Soluble CD26 as a Complementary Biomarker for Colorectal Cancer Screening Programs

Loretta De Chiara et al. Cancers (Basel). .

Abstract

Fecal hemoglobin immunodetection (FIT) in combination with endoscopy has been implemented to reduce mortality from colorectal cancer (CRC), although there are issues that can be improved in relation to participation rates. We studied whether the blood biomarker soluble-CD26 (sCD26), related at least in part to the immune system and inflammation, and/or its dipeptidyl peptidase enzyme activity (DPP4), could help reduce false positives. In a cohort of 1703 individuals who underwent colonoscopy and had a serum sample, sCD26 and DPP4 activity showed statistically significant differences regarding sex and age. According to the colonoscopy findings, sCD26 and DPP4 activity progressively decreased in advanced adenomas and CRC, with statistically significant differences, even between both groups; 918 of them had a FIT result (n = 596 positive cases) with approximately 70% of these (n = 412) false positives. With cut-offs of 440 ng/mL for sCD26, 42 mU/mL for DPP4, and 11 ng/mU for their ratio, the combined information of the three biomarkers (at least positive for one biomarker) identified almost all advanced adenomas and CRC cases in the FIT cohort with approximately half of the false positives compared to FIT. A sequential testing strategy with FIT and our blood biomarker test is proposed.

Keywords: DPP4; FIT; advanced adenomas; blood test; colorectal cancer; endoscopy; soluble CD26.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Frequencies of positive and negative cases from the blood test among FIT positives with no neoplasia (A) and advanced neoplasia (B). (A), proportion of negative cases for sCD26, DDP4 and sCD26/DDP4 among FIT positives with no neoplasia; (B), proportion of positive cases for sCD26, DDP4 and sCD26/DDP4 ratio among FIT positives with advanced neoplasia.
Figure 2
Figure 2
Proposal for the integration of our blood test in FIT-based colorectal cancer screening. 1 sCD26/DPP4 blood test will not be offered to FIT negatives; instead, they will repeat FIT in 2 years.
See this image and copyright information in PMC

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