Rectal mucosal quantitative galactose oxidase-Schiff reaction as an early detection biomarker for colorectal cancer: Comparison to fecal occult stool blood test

Article type: Research Article

Authors: Ruffin, Mack T.^{a; *} | Normolle, Daniel P.^b | Evelegh, Michael J.^c | Baron, John A.^d | Bresalier, Robert S.^e | Marcon, Norman E.^f | Syngal, Sapna^g | Turgeon, D. Kim^h | Tuck, Melissa K.^h | Brenner, Dean E.^{h; i}

Affiliations: [a] University of Michigan, Department of Family Medicine, Ann Arbor, MI, USA | [b] University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA | [c] McMaster University, Hamilton, Ontario, Canada | [d] Dartmouth Medical School, Hanover, NH, USA | [e] MD Anderson Cancer Center, Houston, TX, USA | [f] Saint Michael's Hospital, Toronto, Ontario, Canada | [g] Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA, USA | [h] University of Michigan, Department of Internal Medicine, Ann Arbor, MI, USA | [i] VA Medical Center, Ann Arbor, MI, USA

Correspondence: [*] Corresponding author: Mack T. Ruffin, IV, Department of Family Medicine, University of Michigan Medical Center, 1018 Fuller Street, Ann Arbor, Michigan 48104-1213, USA. Tel.: +1 734 998 7120 ext 310; Fax: +1 734 998 7335; E-mail: mruffin@umich.edu.

Abstract: The galactose oxidase-Schiff (GOS) reaction detects D-galactose-β-[1,3]-N-acetyl-D-galactosamine. This is a T-antigen expressed in mucus from malignant cells and colonic mucosa adjacent to cancer but not in normal mucosa. Previous studies using a qualitative GOS assay proved to be of limited value for the detection of colorectal neoplasia. We used a newly developed quantitative GOS assay to determine its potential as an early detection biomarker for colorectal cancer. We completed a multi-center, prospective, cross-sectional cohort validation study consisting of 70 normal controls, 23 high-risk normal patients (polyp history or family history of colorectal cancer (CRC) with currently normal colonoscopy), 137 patients with adenomatous polyps, and 69 with colorectal cancers. Prior to colonoscopy, two samples of stool were collected via a rectal exam: one for FOBT, and one for GOS. The area under the ROC curve (AUC) for detecting colonic adenomas and cancer for normal colons, computed with logistic regression was 0.69 for GOS, 0.62 for FOBT, and 0.73 for GOS combined with FOBT. Adding GOS to FOBT did not significantly change the ROC of FOBT alone. GOS does not appear to be a suitable marker of colorectal neoplasia.

Keywords: Colorectal Neoplasms/diagnosis, Colorectal Neoplasms/prevention & control, Carcinoma/diagnosis, Galactose Oxidase, Predictive Value of Tests

DOI: 10.3233/CBM-2011-0206

Journal: Cancer Biomarkers, vol. 8, no. 2, pp. 109-112, 2011