Diagnostic value of new combination of methylated Septin9 with LMR in adenomatous polyps and stage I to IV colorectal cancer

Abstract

Abstract Purpose To explore the diagnostic value of tumor markers, inflammatory indicators and methylated Septin9 gene (mSEPT9) alone and combination in adenomatous polyps and stage I to IV colorectal cancer (CRC). Methods Data of mSEPT9, blood routine inflammatory indicators (NLR, LMR, MPV/PC), tumor markers (CEA, CA125, CA19-9) and pathological stage from 420 patients with CRC, 61 patients with adenomatous polyps and 175 healthy people from 2018 to 2022 were retrospectively analyzed. Receiver operating characteristic (ROC) curve was plotted for the assessment of diagnostic accuracy, and statistical data were processed by SPSS 26.0 software. Results The levels of NLR, CEA and CA19-9 in CRC group were significantly higher than those in healthy group, with statistical significance (P < 0.05). The levels of LMR and mSEPT9 in healthy group, polyps group and CRC group were decreased gradually, with statistical among all groups (P < 0.05). With the progressive of CRC from stage I to IV, the LMR levels and Ct value of mSEPT9 decreased gradually, and mSEPT9 in stage I/II, III and IV groups was significantly different (P < 0.05). The sensitivity of mSEPT9 increased gradually with the progression of stage, from 56.1% in stage I to 100% in stage IV. MSEPT9 was the most valuable single indicator in the diagnosis of CRC, and its sensitivity, specificity and AUC were 70.0%, 94.3% and 0.830, respectively. LMR was the most valuable single indicator in the diagnosis of adenomatous polyps, and its sensitivity, specificity and AUC were 78.7%, 57.1% and 0.732, respectively. MSEPT9 combined with LMR was the most valuable combination in the diagnosis of CRC and adenomatous polyps, and its sensitivity, specificity and AUC were 82.3% and 82.0%, 90.3% and 54.9%, 0.917 and 0.759, respectively. Conclusions The new combination of mSEPT9 with LMR showed the best diagnostic value in the whole process of CRC occurrence and development, it should be used as the first choice for high-risk population screening, adjuvant diagnosis of CRC and disease staging.