PT - JOURNAL ARTICLE AU - Sunny H Wong AU - Thomas N Y Kwong AU - Tai-Cheong Chow AU - Arthur K C Luk AU - Rudin Z W Dai AU - Geicho Nakatsu AU - Thomas Y T Lam AU - Lin Zhang AU - Justin C Y Wu AU - Francis K L Chan AU - Simon S M Ng AU - Martin C S Wong AU - Siew C Ng AU - William K K Wu AU - Jun Yu AU - Joseph J Y Sung TI - Quantitation of faecal <em>Fusobacterium</em> improves faecal immunochemical test in detecting advanced colorectal neoplasia AID - 10.1136/gutjnl-2016-312766 DP - 2017 Aug 01 TA - Gut PG - 1441--1448 VI - 66 IP - 8 4099 - http://gut.bmj.com/content/66/8/1441.short 4100 - http://gut.bmj.com/content/66/8/1441.full SO - Gut2017 Aug 01; 66 AB - Objective There is a need for an improved biomarker for colorectal cancer (CRC) and advanced adenoma. We evaluated faecal microbial markers for clinical use in detecting CRC and advanced adenoma.Design We measured relative abundance of Fusobacterium nucleatum (Fn), Peptostreptococcus anaerobius (Pa) and Parvimonas micra (Pm) by quantitative PCR in 309 subjects, including 104 patients with CRC, 103 patients with advanced adenoma and 102 controls. We evaluated the diagnostic performance of these biomarkers with respect to faecal immunochemical test (FIT), and validated the results in an independent cohort of 181 subjects.Results The abundance was higher for all three individual markers in patients with CRC than controls (p&lt;0.001), and for marker Fn in patients with advanced adenoma than controls (p=0.022). The marker Fn, when combined with FIT, showed superior sensitivity (92.3% vs 73.1%, p&lt;0.001) and area under the receiver-operating characteristic curve (AUC) (0.95 vs 0.86, p&lt;0.001) than stand-alone FIT in detecting CRC in the same patient cohort. This combined test also increased the sensitivity (38.6% vs 15.5%, p&lt;0.001) and AUC (0.65 vs 0.57, p=0.007) for detecting advanced adenoma. The performance gain for both CRC and advanced adenoma was confirmed in the validation cohort (p=0.0014 and p=0.031, respectively).Conclusions This study identified marker Fn as a valuable marker to improve diagnostic performance of FIT, providing a complementary role to detect lesions missed by FIT alone. This simple approach may improve the clinical utility of the current FIT, and takes one step further towards a non-invasive, potentially more accurate and affordable diagnosis of advanced colorectal neoplasia.