الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
CRC is ranking as the third most frequent cause of cancer and the second most frequent cause of death from cancer worldwide.
Risk factors for CRC include old age, male gender, high intake of fat and alcohol, obesity, and smoking.
CEA and CA19-9 are usually used serum markers for the diagnosis of CRC, however, they are neither sufficient nor specific for the diagnosis of CRC. Colonoscopy is the gold standard method used for screening and early detection of CRC. Despite its benefit, it is an invasive and a high-cost procedure.
Non coding RNAs are involved in numerous biological processes and in human malignancies. Certain lncRNAs have been identified as potential biomarkers for CRC, one of them is H19. Many studies showed that H19 was overexpressed in tissues of many malignancies. Also it was reported that H19 regulates the activity of beta-catenin, a protein that participates in the regulation of cell - cell adhesion and transcription of genes.
The aim of the current work was to study the serum H19 and beta-catenin as biomarkers for the early diagnosis of CRC and to compare the serum H19 and beta-catenin levels to the level of other conventional serum CRC biomarkers (CEA and CA19-9).
The study included 80 patients attended the Department of gastroenterology, Alexandria Main University Hospital. Patients were divided into two groups: group I included 40 CRC patients and group II included 40 colorectal polyp patients. Twenty age- and sex-matched healthy subjects were included as a control (group III). Diagnosis of patients was performed by colonoscopy. Blood samples were taken from every patient and healthy control and serum was separated and stored at -70 °C untill assay.
The following investigations were performed for all subjects:
• Measurement of CEA using two-site sequential chemiluminescent immunometric assay and CA19-9 using ELISA.
• Determination of circulating H19 using q-PCR.
• Measurement of serum level of beta-catenin using ELISA.
Statistical analysis of the studied parameters showed the following results:
• Serum CEA and CA19-9 levels in group I (CRC patients) were significantly higher than in group II (colonic polyp patients) and group III (control), while there was no significant difference between groups II and III.
• Serum expression of H19 in group I (CRC patients) was significantly higher than in group II (colonic polyp patients) and group III (control), while there was no significant difference between groups II and III.
• Serum beta-catenin levels in group I (CRC patients) was significantly higher than in group II (colonic polyp patients) and group III (control), while there was no significant difference between groups II and III.
• Serum H19 and beta-catenin did not identify a better diagnostic performance versus serum CEA and CA19-9.
• Combination of both H19 and beta-catenin with CEA showed AUC of 0.97 and specificity of 96.67%. Moreover on combining both markers with CA19-9, the AUC became 0.948 and the specificity became 90% in the detection of CRC.
• Serum expressions of H19 and beta-catenin can significantly discriminate patients with CRC from colonic polyp patients and normal population. Although serum H19 and beta-catenin did not identify a better diagnostic performance over serum CEA or CA19-9 in the discrimination of CRC patients, the combination of both markers with CEA or CA19-9 improved specificity.