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Biology of Human Tumors

Serum miR-21, miR-29a, and miR-125b Are Promising Biomarkers for the Early Detection of Colorectal Neoplasia

Atsushi Yamada, Takahiro Horimatsu, Yoshinaga Okugawa, Naoshi Nishida, Hajime Honjo, Hiroshi Ida, Tadayuki Kou, Toshihiro Kusaka, Yu Sasaki, Makato Yagi, Takuma Higurashi, Norio Yukawa, Yusuke Amanuma, Osamu Kikuchi, Manabu Muto, Yoshiyuki Ueno, Atsushi Nakajima, Tsutomu Chiba, C. Richard Boland and Ajay Goel
Atsushi Yamada
1Center for Gastrointestinal Research, Epigenetics, Cancer Prevention and Cancer Genomics, Baylor Research Institute and Sammons Cancer Center, Baylor University Medical Center, Dallas, Texas.
2Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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Takahiro Horimatsu
3Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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Yoshinaga Okugawa
1Center for Gastrointestinal Research, Epigenetics, Cancer Prevention and Cancer Genomics, Baylor Research Institute and Sammons Cancer Center, Baylor University Medical Center, Dallas, Texas.
4Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Mie, Japan.
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Naoshi Nishida
5Department of Gastroenterology and Hepatology, Kinki University, Faculty of Medicine, Osaka, Japan.
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Hajime Honjo
6Department of Gastroenterology, Otsu Red Cross Hospital, Shiga, Japan.
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Hiroshi Ida
7Internal Medicine, Kyoto Police Hospital, Kyoto, Japan.
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Tadayuki Kou
8Digestive Disease Center, The Tazuke Kofukai Medical Research Institute Kitano Hospital, Osaka, Japan.
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Toshihiro Kusaka
9Department of Gastroenterology and Hepatology, Kyoto Katsura Hospital, Kyoto, Japan.
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Yu Sasaki
10Department of Gastroenterology, Faculty of Medicine, Yamagata University, Yamagata, Japan.
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Makato Yagi
10Department of Gastroenterology, Faculty of Medicine, Yamagata University, Yamagata, Japan.
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Takuma Higurashi
11Department of Gastroenterology and Hepatology, Yokohama City University, Yokohama, Japan.
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Norio Yukawa
12Department of Surgery, Yokohama City University School of Medicine, Yokohama, Japan.
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Yusuke Amanuma
2Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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Osamu Kikuchi
2Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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Manabu Muto
3Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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Yoshiyuki Ueno
10Department of Gastroenterology, Faculty of Medicine, Yamagata University, Yamagata, Japan.
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Atsushi Nakajima
11Department of Gastroenterology and Hepatology, Yokohama City University, Yokohama, Japan.
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Tsutomu Chiba
2Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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C. Richard Boland
1Center for Gastrointestinal Research, Epigenetics, Cancer Prevention and Cancer Genomics, Baylor Research Institute and Sammons Cancer Center, Baylor University Medical Center, Dallas, Texas.
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  • For correspondence: ajay.goel@baylorhealth.edu rickbo@baylorhealth.edu
Ajay Goel
1Center for Gastrointestinal Research, Epigenetics, Cancer Prevention and Cancer Genomics, Baylor Research Institute and Sammons Cancer Center, Baylor University Medical Center, Dallas, Texas.
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  • For correspondence: ajay.goel@baylorhealth.edu rickbo@baylorhealth.edu
DOI: 10.1158/1078-0432.CCR-14-2793 Published September 2015
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    Figure 1.

    Schematic representation of the approach used for candidate miRNA biomarker selection in this study. HC, healthy control.

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    Figure 2.

    Serum levels of candidate miRNA biomarkers in the screening phase. Levels of serum miR-18a, miR-19a, miR-19b, miR-20a, miR-21, miR-24, miR-29a, miR-92a, and miR-125b were compared between healthy controls (HC) and early colorectal neoplasm patients. The Mann–Whitney U test was performed for comparisons between groups.

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    Figure 3.

    Serum miR-21, miR-29a, and miR-125b in the validation phase. A, levels of miRNAs were compared between healthy controls (HC) and early colorectal neoplasia patients. Statistical analyses were performed using the Mann–Whitney U test. B, levels of miRNAs were compared among HCs, patients with non-advanced neoplasia (AN) colorectal neoplasms (non-AN), and patients with ANs (AN). All-pairs multiple comparison was conducted by the Steel–Dwass test. C, correlation between levels of serum miRNAs and the size of the index lesion. Spearman rank correlation coefficient (ρ) is shown.

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    Figure 4.

    ROC curves for miR-21, miR-29a, miR-125b and the combination of the 3 miRNAs in discriminating patients with early colorectal neoplasms from healthy controls (HCs; A) and in discriminating patients with advanced neoplasias (AN) from individuals without ANs (B). AUC values are shown.

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    Figure 5.

    A, serum miR-21, miR-29a, and miR-125b in patients with small colorectal neoplasms. Levels of miRNAs were compared among healthy controls (HC), patients with small colorectal neoplasms (total diameter of colorectal neoplasms in an individual ≤ 5 mm, sCRN), and those with larger colorectal neoplasms (total diameter of colorectal neoplasms > 5 mm, non-sCRN). All-pairs multiple comparison was conducted by the Steel–Dwass test. B, serum miRNA levels according to various histologic subtypes of colorectal neoplasms. Statistical analysis was conducted by the Steel–Dwass test, and significant differences of miRNA levels compared with HCs are noted. a, P < 0.05; b, P < 0.01; c, P < 0.0001.

Tables

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  • Table 1.

    Clinicopathologic characteristics of study subjects

    Screening setValidation set
    HCCRNHCCRN
    (n = 25)(n = 24)(n = 52)(n = 136)
    Age, y
     Median (range)34 (22–49)67 (37–84)58 (23–77)68 (37–86)
    Gender
     Male (%)19 (76.0)13 (54.2)23 (44.2)93 (68.4)
     Female (%)6 (24.0)11 (45.8)29 (55.8)43 (31.6)
    Locationa
     Right (%)—13 (54.2)—32 (23.7)
     Left (%)—7 (29.2)—55 (40.7)
     Both (%)—4 (16.7)—48 (35.6)
    Morphology
     Protruded (%)—3 (12.5)—45 (33.1)
     Superficial (%)—13 (54.2)—59 (43.4)
     Both (%)—8 (33.3)—32 (23.5)
    Size of the index lesion, mm
     Median (range)—8 (4–32)—10 (3–55)
    Number of neoplastic lesions
     Median (range)—2 (1–9)—1.5 (1–16)
    Histology of the index lesion
     LGIN—12 (50.0)—94 (69.1)
      Tubular adenoma—12 (50.0)—70 (51.5)
      Tubulovillous adenoma—0 (0.0)—15 (11.0)
      Sessile serrated polyp/adenoma—0 (0.0)—5 (3.7)
      Traditional serrated adenoma—0 (0.0)—2 (1.5)
      Mixed serrated polyp—0 (0.0)—2 (1.5)
     HGIN—8 (33.3)—34 (25.0)
     Cancer—4 (16.7)—8 (5.9)

    Abbreviations: HC, healthy control, CRN, colorectal neoplasia.

    • ↵aLocation of one case in the validation phase was unknown.

Additional Files

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    • Figure Legends for Supplementary Figures - Figure Legends for Supplementary Figures
    • Supplementary Figure 1 - Supplementary figure 1: Expression levels of serum miR-21, miR-29a and miR-125b in healthy controls (HC) vs. patients with colorectal neoplasms (CRN), after exclusion of 8 patients with colorectal cancer.
    • Supplementary Figure 2 - Supplementary figure 2: Kaplan Meier survival curves based upon expression levels of miR-21, miR-29a, miR-125b and their combination, when comparing patients with colorectal neoplasms (CRN) with healthy controls (HC), and when comparing patients with advanced neoplasms (AN) with patients without advanced neoplasms (non-AN), after exclusion of all patients with colorectal cancer.
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Clinical Cancer Research: 21 (18)
September 2015
Volume 21, Issue 18
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Serum miR-21, miR-29a, and miR-125b Are Promising Biomarkers for the Early Detection of Colorectal Neoplasia
Atsushi Yamada, Takahiro Horimatsu, Yoshinaga Okugawa, Naoshi Nishida, Hajime Honjo, Hiroshi Ida, Tadayuki Kou, Toshihiro Kusaka, Yu Sasaki, Makato Yagi, Takuma Higurashi, Norio Yukawa, Yusuke Amanuma, Osamu Kikuchi, Manabu Muto, Yoshiyuki Ueno, Atsushi Nakajima, Tsutomu Chiba, C. Richard Boland and Ajay Goel
Clin Cancer Res September 15 2015 (21) (18) 4234-4242; DOI: 10.1158/1078-0432.CCR-14-2793

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Serum miR-21, miR-29a, and miR-125b Are Promising Biomarkers for the Early Detection of Colorectal Neoplasia
Atsushi Yamada, Takahiro Horimatsu, Yoshinaga Okugawa, Naoshi Nishida, Hajime Honjo, Hiroshi Ida, Tadayuki Kou, Toshihiro Kusaka, Yu Sasaki, Makato Yagi, Takuma Higurashi, Norio Yukawa, Yusuke Amanuma, Osamu Kikuchi, Manabu Muto, Yoshiyuki Ueno, Atsushi Nakajima, Tsutomu Chiba, C. Richard Boland and Ajay Goel
Clin Cancer Res September 15 2015 (21) (18) 4234-4242; DOI: 10.1158/1078-0432.CCR-14-2793
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