INTRODUCTION: The objective was to evaluate a new method for DNA sampling from the rectal mucosa for the detection of colorectal cancer or any clinically significant pathology in the colon and rectum. METHODS: This prospective cohort study included patients scheduled for colonoscopy (group 1, n = 185) or colonic resection because of suspected colorectal cancer (group 2, n = 62). A test instrument with a balloon-holding end was introduced through a proctoscope into the rectum to collect exfoliated cells, from which DNA was isolated and quantified. RESULTS: The detection of colorectal cancer in group 1 showed a sensitivity for the DNA cut-off levels 1.5, 2, and 2.5 microg/ml of 100%, 80%, and 60%, and a specificity of 37%, 46%, and 56%, respectively. In group 2, for the same cut-off levels, the sensitivity was 73%, 61%, and 55%, and the specificity was 67%, 67%, and 67%, respectively. CONCLUSIONS: This novel technique is a safe and easy way of collecting DNA from the rectal mucosa. The sensitivity and specificity of the test were too low to be acceptable for a screening test. The low sensitivity and specificity in this study could be explained by the diversity within the study groups as many patients presented with long-term history of colorectal disease and surgical interventions in the past.
INTRODUCTION: The objective was to evaluate a new method for DNA sampling from the rectal mucosa for the detection of colorectal cancer or any clinically significant pathology in the colon and rectum. METHODS: This prospective cohort study included patients scheduled for colonoscopy (group 1, n = 185) or colonic resection because of suspected colorectal cancer (group 2, n = 62). A test instrument with a balloon-holding end was introduced through a proctoscope into the rectum to collect exfoliated cells, from which DNA was isolated and quantified. RESULTS: The detection of colorectal cancer in group 1 showed a sensitivity for the DNA cut-off levels 1.5, 2, and 2.5 microg/ml of 100%, 80%, and 60%, and a specificity of 37%, 46%, and 56%, respectively. In group 2, for the same cut-off levels, the sensitivity was 73%, 61%, and 55%, and the specificity was 67%, 67%, and 67%, respectively. CONCLUSIONS: This novel technique is a safe and easy way of collecting DNA from the rectal mucosa. The sensitivity and specificity of the test were too low to be acceptable for a screening test. The low sensitivity and specificity in this study could be explained by the diversity within the study groups as many patients presented with long-term history of colorectal disease and surgical interventions in the past.
Authors: J S Mandel; T R Church; J H Bond; F Ederer; M S Geisser; S J Mongin; D C Snover; L M Schuman Journal: N Engl J Med Date: 2000-11-30 Impact factor: 91.245
Authors: Corné H W Klaassen; Marcel A F Jeunink; Clemens F M Prinsen; Theo J M Ruers; Adriaan C I T L Tan; Luc J A Strobbe; Frederik B J M Thunnissen Journal: Clin Chem Date: 2003-07 Impact factor: 8.327
Authors: T Yamao; Y Matsumura; Y Shimada; Y Moriya; K Sugihara; T Akasu; S Fujita; T Kakizoe Journal: Gastroenterology Date: 1998-06 Impact factor: 22.682
Authors: J D Hardcastle; J O Chamberlain; M H Robinson; S M Moss; S S Amar; T W Balfour; P D James; C M Mangham Journal: Lancet Date: 1996-11-30 Impact factor: 79.321
Authors: James E Allison; Lori C Sakoda; Theodore R Levin; Jo P Tucker; Irene S Tekawa; Thomas Cuff; Mary Pat Pauly; Lyle Shlager; Albert M Palitz; Wei K Zhao; J Sanford Schwartz; David F Ransohoff; Joseph V Selby Journal: J Natl Cancer Inst Date: 2007-09-25 Impact factor: 13.506