PCR amplification was performed using a 7500 selleck products Real-Time PCR System (Applied Biosystems). Each sample was tested in duplicate reactions on the same PCR plate. The run results were subjected to quality control processes, and failed samples were repeated. Samples that failed a second time were excluded from the analysis. For the blind test set, first, we selected samples with HM781-36B disease status
known (in order to balance the sample groups and avoid biases in clinical and demographic characteristics). Selected samples were then randomized and assigned blinded identification prior to the experiment, and data analysis was performed by scientists blinded to the disease status. The seven-gene panel Details of the characterization and validation of the seven-gene panel to identify CRC have been
described previously [10]. In that study a seven-gene panel (ANXA3, CLEC4D, LMNB1, PRRG4, TNFAIP6, VNN1, IL2RB) discriminated CRC in the training set [area under the receiver-operating-characteristic curve (AUC ROC), 0.80; accuracy, 73%; sensitivity, 82%; specificity 64%]. The independent blind test set confirmed performance (AUC ROC, 0.80; accuracy, 71%; sensitivity, 72%; specificity, 70%). For the present study we re-analyze the previously reported data in order to determine the ability of the seven gene panel not only to identify the presence of CRC but also to identify cancer stages and left- and right-sided Selleck AICAR colon cancer. Results The training set data was used to determine the best coefficients for a logistic regression model using 6 ratios of the 7 genes most discriminative for CRC. This model was then used to predict the CRC risk for the test set samples. Breaking the data down by cancer stages, we were
able to find the same predictive values for left- and right-sided cancers as for CRC detection as in the original paper (Table 2). Table 2 Correct call rate Training Test 1000X 2-Fold Cross validation Stage Left Right Left Right Left Right TNM I 63% 92% 61% 44% 67% 66% (12/19) (11/12) (28/46) (7/16) (43.5/65) (18.6/28) TNM II 70% 91% 81% 89% 79% Depsipeptide clinical trial 89% (14/20) (10/11) (30/37) (16/18) (45.0/57) (25.9/29) TNM III 86% 100% 74% 84% 83% 90% (18/21) (13/13) (29/39) (21/25) (49.6/60) (34.3/38) TNM IV 86% 100% 50% 100% 66% 100% (6/7) (5/5) (5/10) (7/7) (11.2/17) (12.0/12) Unknown 80% 100% 100% n/a 80% 100% (4/5) (1/1) (4/4) (0/0) (7.2/9) (1.0/1) All Stages 75% 95% 71% 77% 75% 85% (54/72) (40/42) (96/136) (51/66) (156.5/208) (91.8/108) Control 64% (77/120) 70% (145/208) 64% (210/328) In this study, CRC detection sensitivity was generally higher for right-sided cancer except in the case of TNM stage I in the test set. However, this finding may be simply a sampling issue. To resolve this question, we combined all training and test set samples and performed 2-fold cross validation, iterated 1000 times.