الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Colorectal cancer is one of the most prevalent types of cancer worldwide. With 35% of patients under the age of 40, Egypt has the highest rate of early CRC. Early CRC is frequently asymptomatic. Most patients are diagnosed after the tumor has invaded and spread.
Blood tumor marker detection for cancer screening is straightforward, inexpensive, and noninvasive. Unfortunately, traditional markers (CEA and CA19-9) are not sensitive enough for the early detection of CRC. CRC patients were recently found to have altered serum/plasma noncoding RNA profiles when compared to healthy people.
PIWI-interacting RNAs (piRNAs) are a new class of small non-coding RNAs. Several piRNAs have been identified as oncogenes in CRC. It was discovered that piRNA-54265 increased CRC cell proliferation and invasiveness via the STAT3 pathway.
This study aimed to investigate whether serum piRNA-54265 could be used as a non-invasive biomarker for CRC. Additionally, it aimed to compare the levels of piRNA-54265 with other commonly used tumour markers, such as CEA and CA19-9.
The present study included 40 CRC patients (group I). The patients were further subdivided into two subgroups based on their TNM stage. group Ia comprised the early-stage CRC patients (stages I and II) and group Ib comprised the late-stage CRC patients (stages III and IV). group II included 30 age and sex-matched healthy controls.
Serum CA19-9 was measured using ELISA and serum CEA was measured using two-site sequential chemiluminescent immunometric assay. Total RNA was extracted from serum samples followed by reverse transcription using stem-loop primers and then real-time PCR for piRNA-54265. The comparative cycle threshold (Ct) approach was used to calculate the relative expression of serum piRNA-54265 (2–ΔΔCt).
Statistical analysis of the studied parameters showed the following results:
• In the early-stage CRC group, no difference was observed between the levels of serum CEA and CA19-9 compared to the control group. However, in the late-stage group, there was a significant increase observed when compared to both the early-stage group and the control.
• Serum piRNA-54265 expression levels were elevated in a manner dependent on the stage of CRC, with the highest levels found in patients with advanced CRC.
• piRNA-54265 demonstrated the highest sensitivity (97.5%) and specificity (100%) as a diagnostic marker for CRC, as determined by a ROC curve. The sensitivity and specificity of CEA in diagnosing CRC patients were 75% and 96.67%, respectively. In contrast, the sensitivity of CA19-9 was 75%, and the specificity was 63.3%.
• The sensitivity of piRNA-54265 as an early diagnostic marker for CRC was found to be 94.4%, while its specificity was found to be 100%.
• Serum CEA and CA 19-9 were unable to differentiate between the early stages of CRC and healthy controls