Identification of microRNA-135b in stool as a potential noninvasive biomarker for colorectal cancer and adenoma

Chung Wah Wu, Siew Chien Ng, Yujuan Dong, Linwei Tian, Simon Siu Man Ng, Wing Wa Leung, Wai Tak Law, Tung On Yau, Francis Ka Leung Chan, Joseph Jao Yiu Sung, Jun Yu

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122 Citations (Scopus)


PURPOSE: Detecting microRNA (miRNA) in stool is a novel approach for colorectal cancer (CRC) screening. This study aimed to identify stool-based miRNA as noninvasive biomarkers for detection of CRC and adenoma.

EXPERIMENTAL DESIGN: A miRNA expression array covering 667 human miRNAs was performed on five pairs of CRC and two pairs of advanced adenoma tissues. The most upregulated miRNAs were validated in 40 pairs of CRC tissues, 16 pairs of advanced adenoma tissues, and 424 stool samples, including 104 CRCs, 169 adenomas, 42 inflammatory bowel diseases (IBD), and 109 healthy controls. miRNA levels were followed-up after removal of lesions.

RESULTS: In an array analysis, miR-31 and miR-135b were the most upregulated miRNAs in CRC and advanced adenoma as compared with their adjacent normal tissues (>13-fold increase). In stool samples, level of miR-135b was significantly higher in subjects with CRC (P < 0.0001) or adenomas (P < 0.0001), but not in patients with IBD compared with controls. miR-135b showed a significant increasing trend across the adenoma to cancer sequence (P < 0.0001). Levels of miR-31 were not significantly different among groups. The sensitivity of stool mR-135b was 78% for CRC, 73% for advanced adenoma, and 65% for any adenoma, respectively, with a specificity of 68%. No significant difference in the miR-135b level was found between proximal and distal colorectal lesions. Stool miR-135b dropped significantly upon removal of CRC or advanced adenoma (P < 0.0001).

CONCLUSION: Stool-based miR-135b can be used as a noninvasive biomarker for the detection of CRC and advanced adenoma. Clin Cancer Res; 20(11); 2994-3002. ©2014 AACR.

Original languageEnglish
Pages (from-to)2994-3002
Number of pages9
JournalClinical Cancer Research
Issue number11
Publication statusPrint publication - 1 Jun 2014
Externally publishedYes


  • Adenocarcinoma/diagnosis
  • Adenoma/diagnosis
  • Aged
  • Biomarkers, Tumor/analysis
  • Case-Control Studies
  • Colorectal Neoplasms/diagnosis
  • Early Detection of Cancer/methods
  • Feces/chemistry
  • Female
  • Humans
  • Male
  • MicroRNAs/analysis
  • Middle Aged
  • Oligonucleotide Array Sequence Analysis
  • Real-Time Polymerase Chain Reaction
  • Sensitivity and Specificity


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