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Published in: BMC Cancer 1/2023

Open Access 01-12-2023 | Colorectal Cancer | Research

Quantification of mitochondrial cfDNA reveals new perspectives for early diagnosis of colorectal cancer

Authors: Christian Linke, Richard Hunger, Mark Reinwald, Markus Deckert, René Mantke

Published in: BMC Cancer | Issue 1/2023

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Abstract

Background

To unravel how the integrity of nuclear and mitochondrial circulating cell-free DNA (cfDNA) contributes to its plasma quantity in colorectal cancer (CRC) patients.

Methods

CfDNA from plasma samples of 80 CRC patients stratified by tumour stage and 50 healthy individuals were extracted. Total cfDNA concentration was determined and equal template concentrations (ETC) were analyzed by quantitative real-time PCR (qPCR) resulting in small and long fragments of KRAS, Alu and MTCO3. The obtained data was also examined relative to the total cfDNA concentration (NTC) and diagnostic accuracy was estimated using receiver operating characteristics.

Results

Total cfDNA levels were significantly higher in CRC group compared to healthy control and increased with tumour stage. Long nuclear fragment levels were significantly lower in CRC patients in ETC but not NTC condition. The integrity indices of nuclear cfDNA decreased from controls to patients with highly malignant tumor. Mitochondrial cfDNA fragment quantities were strongly reduced in early and late stages of tumor patients and prognostic value was higher in ETC. Predictive models based on either ETC or NTC predictor set showed comparable classification performance.

Conclusion

Increased blood cfDNA concentration in late UICC stages inversely correlate with nuclear cfDNA integrity index and suggest that necrotic degradation is not a major cause for higher total cfDNA quantity. The diagnostic and prognostic value of MTCO3 is highly significant in early stages of CRC and can be evaluated more comprehensively, using ETC for qPCR analysis.

Trial registration

The study was registered retrospectively on DRKS, the german register for clinical trials (DRKS00030257, 29/09/2022).
Appendix
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Literature
1.
go back to reference Labianca R, Nordlinger B, Beretta GD, Mosconi S, Mandalà M, Cervantes A, et al. Early colon cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013;24(Suppl 6):vi64-72.PubMedCrossRef Labianca R, Nordlinger B, Beretta GD, Mosconi S, Mandalà M, Cervantes A, et al. Early colon cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013;24(Suppl 6):vi64-72.PubMedCrossRef
2.
go back to reference Davis DM, Marcet JE, Frattini JC, Prather AD, Mateka JJ, Nfonsam VN. Is it time to lower the recommended screening age for colorectal cancer? J Am Coll Surg. 2011;213(3):352–61.PubMedCrossRef Davis DM, Marcet JE, Frattini JC, Prather AD, Mateka JJ, Nfonsam VN. Is it time to lower the recommended screening age for colorectal cancer? J Am Coll Surg. 2011;213(3):352–61.PubMedCrossRef
3.
go back to reference O’Connell JB, Maggard MA, Ko CY. Colon cancer survival rates with the new American Joint Committee on Cancer sixth edition staging. J Nat Cancer Inst. 2004;96(19):1420–5.PubMedCrossRef O’Connell JB, Maggard MA, Ko CY. Colon cancer survival rates with the new American Joint Committee on Cancer sixth edition staging. J Nat Cancer Inst. 2004;96(19):1420–5.PubMedCrossRef
5.
go back to reference Ore L, Hagoel L, Lavi I, Rennert G. Screening with faecal occult blood test (FOBT) for colorectal cancer: assessment of two methods that attempt to improve compliance. Eur J Cancer Prev. 2001;10(3):251–6.PubMedCrossRef Ore L, Hagoel L, Lavi I, Rennert G. Screening with faecal occult blood test (FOBT) for colorectal cancer: assessment of two methods that attempt to improve compliance. Eur J Cancer Prev. 2001;10(3):251–6.PubMedCrossRef
6.
go back to reference Ibañez-Sanz G, Garcia M, Milà N, Rodríguez-Moranta F, Binefa G, Gómez-Matas J, et al. False-negative rate cannot be reduced by lowering the haemoglobin concentration cut-off in colorectal cancer screening using faecal immunochemical test. Eur J Cancer Prev. 2017;26(5):365–7.PubMedCrossRef Ibañez-Sanz G, Garcia M, Milà N, Rodríguez-Moranta F, Binefa G, Gómez-Matas J, et al. False-negative rate cannot be reduced by lowering the haemoglobin concentration cut-off in colorectal cancer screening using faecal immunochemical test. Eur J Cancer Prev. 2017;26(5):365–7.PubMedCrossRef
7.
go back to reference Ibáñez-Sanz G, Milà N, de la Peña-Negro LC, Garcia M, Vidal C, Rodríguez-Alonso L, et al. Proton-pump inhibitors are associated with a high false-positivity rate in faecal immunochemical testing. J Gastroenterol. 2021;56(1):42–53.PubMedCrossRef Ibáñez-Sanz G, Milà N, de la Peña-Negro LC, Garcia M, Vidal C, Rodríguez-Alonso L, et al. Proton-pump inhibitors are associated with a high false-positivity rate in faecal immunochemical testing. J Gastroenterol. 2021;56(1):42–53.PubMedCrossRef
8.
go back to reference Herrera M, Galindo-Pumariño C, García-Barberán V, Peña C. A snapshot of the tumor microenvironment in colorectal cancer: the liquid biopsy. Int J Mol Sci. 2019;20(23):6016.PubMedPubMedCentralCrossRef Herrera M, Galindo-Pumariño C, García-Barberán V, Peña C. A snapshot of the tumor microenvironment in colorectal cancer: the liquid biopsy. Int J Mol Sci. 2019;20(23):6016.PubMedPubMedCentralCrossRef
11.
go back to reference Cervena K, Vodicka P, Vymetalkova V. Diagnostic and prognostic impact of cell-free DNA in human cancers: systematic review. Mutat Res, Rev Mutat Res. 2019;781:100–29.PubMedCrossRef Cervena K, Vodicka P, Vymetalkova V. Diagnostic and prognostic impact of cell-free DNA in human cancers: systematic review. Mutat Res, Rev Mutat Res. 2019;781:100–29.PubMedCrossRef
12.
go back to reference Petit J, Carroll G, Gould T, Pockney P, Dun M, Scott RJ. Cell-free DNA as a diagnostic blood-based biomarker for colorectal cancer: a systematic review. J Surg Res. 2019;236:184–97.PubMedCrossRef Petit J, Carroll G, Gould T, Pockney P, Dun M, Scott RJ. Cell-free DNA as a diagnostic blood-based biomarker for colorectal cancer: a systematic review. J Surg Res. 2019;236:184–97.PubMedCrossRef
13.
go back to reference Umetani N, Kim J, Hiramatsu S, Reber HA, Hines OJ, Bilchik AJ, et al. Increased integrity of free circulating DNA in sera of patients with colorectal or periampullary cancer: direct quantitative PCR for ALU repeats. Clin Chem. 2006;52(6):1062–9.PubMedCrossRef Umetani N, Kim J, Hiramatsu S, Reber HA, Hines OJ, Bilchik AJ, et al. Increased integrity of free circulating DNA in sera of patients with colorectal or periampullary cancer: direct quantitative PCR for ALU repeats. Clin Chem. 2006;52(6):1062–9.PubMedCrossRef
14.
go back to reference El-Gayar D, El-Abd N, Hassan N, Ali R. Increased free circulating DNA integrity index as a serum biomarker in patients with colorectal carcinoma. Asian Pac J Cancer Prev. 2016;17(3):939–44.PubMedCrossRef El-Gayar D, El-Abd N, Hassan N, Ali R. Increased free circulating DNA integrity index as a serum biomarker in patients with colorectal carcinoma. Asian Pac J Cancer Prev. 2016;17(3):939–44.PubMedCrossRef
15.
go back to reference Jahr S, Hentze H, Englisch S, Hardt D, Fackelmayer FO, Hesch RD, et al. DNA fragments in the blood plasma of cancer patients: quantitations and evidence for their origin from apoptotic and necrotic cells. Can Res. 2001;61(4):1659–65. Jahr S, Hentze H, Englisch S, Hardt D, Fackelmayer FO, Hesch RD, et al. DNA fragments in the blood plasma of cancer patients: quantitations and evidence for their origin from apoptotic and necrotic cells. Can Res. 2001;61(4):1659–65.
16.
go back to reference Duffy MJ, Synnott NC, Crown J. Mutant p53 as a target for cancer treatment. Eur J Cancer. 2017;83:258–65.PubMedCrossRef Duffy MJ, Synnott NC, Crown J. Mutant p53 as a target for cancer treatment. Eur J Cancer. 2017;83:258–65.PubMedCrossRef
17.
go back to reference da Silva Filho BF, Gurgel AP, Neto M, de Azevedo DA, de Freitas AC, Silva Neto Jda C, et al. Circulating cell-free DNA in serum as a biomarker of colorectal cancer. J Clin Pathol. 2013;66(9):775–8.PubMedCrossRef da Silva Filho BF, Gurgel AP, Neto M, de Azevedo DA, de Freitas AC, Silva Neto Jda C, et al. Circulating cell-free DNA in serum as a biomarker of colorectal cancer. J Clin Pathol. 2013;66(9):775–8.PubMedCrossRef
18.
go back to reference Hao TB, Shi W, Shen XJ, Qi J, Wu XH, Wu Y, et al. Circulating cell-free DNA in serum as a biomarker for diagnosis and prognostic prediction of colorectal cancer. Br J Cancer. 2014;111(8):1482–9.PubMedPubMedCentralCrossRef Hao TB, Shi W, Shen XJ, Qi J, Wu XH, Wu Y, et al. Circulating cell-free DNA in serum as a biomarker for diagnosis and prognostic prediction of colorectal cancer. Br J Cancer. 2014;111(8):1482–9.PubMedPubMedCentralCrossRef
19.
go back to reference Leszinski G, Lehner J, Gezer U, Holdenrieder S. Increased DNA integrity in colorectal cancer. In Vivo. 2014;28(3):299–303.PubMed Leszinski G, Lehner J, Gezer U, Holdenrieder S. Increased DNA integrity in colorectal cancer. In Vivo. 2014;28(3):299–303.PubMed
20.
go back to reference Salem R, Ahmed R, Shaheen K, Abdalmegeed M, Hassan H. DNA integrity index as a potential molecular biomarker in colorectal cancer. Egyptian J Med Human Genet. 2020;21(1):38.CrossRef Salem R, Ahmed R, Shaheen K, Abdalmegeed M, Hassan H. DNA integrity index as a potential molecular biomarker in colorectal cancer. Egyptian J Med Human Genet. 2020;21(1):38.CrossRef
21.
go back to reference Mead R, Duku M, Bhandari P, Cree IA. Circulating tumour markers can define patients with normal colons, benign polyps, and cancers. Br J Cancer. 2011;105(2):239–45.PubMedPubMedCentralCrossRef Mead R, Duku M, Bhandari P, Cree IA. Circulating tumour markers can define patients with normal colons, benign polyps, and cancers. Br J Cancer. 2011;105(2):239–45.PubMedPubMedCentralCrossRef
22.
go back to reference Bedin C, Enzo MV, Del Bianco P, Pucciarelli S, Nitti D, Agostini M. Diagnostic and prognostic role of cell-free DNA testing for colorectal cancer patients. Int J Cancer. 2017;140(8):1888–98.PubMedCrossRef Bedin C, Enzo MV, Del Bianco P, Pucciarelli S, Nitti D, Agostini M. Diagnostic and prognostic role of cell-free DNA testing for colorectal cancer patients. Int J Cancer. 2017;140(8):1888–98.PubMedCrossRef
23.
go back to reference Yörüker EE, Özgür E, Keskin M, Dalay N, Holdenrieder S, Gezer U. Assessment of circulating serum DNA integrity in colorectal cancer patients. Anticancer Res. 2015;35(4):2435–40.PubMed Yörüker EE, Özgür E, Keskin M, Dalay N, Holdenrieder S, Gezer U. Assessment of circulating serum DNA integrity in colorectal cancer patients. Anticancer Res. 2015;35(4):2435–40.PubMed
24.
go back to reference Mouliere F, Robert B, Arnau Peyrotte E, Del Rio M, Ychou M, Molina F, et al. High fragmentation characterizes tumour-derived circulating DNA. PLoS ONE. 2011;6(9):e23418.PubMedPubMedCentralCrossRef Mouliere F, Robert B, Arnau Peyrotte E, Del Rio M, Ychou M, Molina F, et al. High fragmentation characterizes tumour-derived circulating DNA. PLoS ONE. 2011;6(9):e23418.PubMedPubMedCentralCrossRef
25.
go back to reference Pu W, Xiao L, Zhou C, Zhong F, Wu Y, Gong W, et al. Cancer stage-dependent alterations in cell-free DNA in patients with colorectal cancer. J BUON. 2021;26(1):109–15.PubMed Pu W, Xiao L, Zhou C, Zhong F, Wu Y, Gong W, et al. Cancer stage-dependent alterations in cell-free DNA in patients with colorectal cancer. J BUON. 2021;26(1):109–15.PubMed
26.
go back to reference Bhangu JS, Taghizadeh H, Braunschmid T, Bachleitner-Hofmann T, Mannhalter C. Circulating cell-free DNA in plasma of colorectal cancer patients - a potential biomarker for tumor burden. Surg Oncol. 2017;26(4):395–401.PubMedCrossRef Bhangu JS, Taghizadeh H, Braunschmid T, Bachleitner-Hofmann T, Mannhalter C. Circulating cell-free DNA in plasma of colorectal cancer patients - a potential biomarker for tumor burden. Surg Oncol. 2017;26(4):395–401.PubMedCrossRef
27.
go back to reference Sinha S, Brown H, Tabak J, Fang Z, Tertre MCD, McNamara S, et al. Multiplexed real-time polymerase chain reaction cell-free DNA assay as a potential method to monitor stage IV colorectal cancer. Surgery. 2019;166(4):534–9.PubMedCrossRef Sinha S, Brown H, Tabak J, Fang Z, Tertre MCD, McNamara S, et al. Multiplexed real-time polymerase chain reaction cell-free DNA assay as a potential method to monitor stage IV colorectal cancer. Surgery. 2019;166(4):534–9.PubMedCrossRef
28.
29.
go back to reference Clay Montier LL, Deng JJ, Bai Y. Number matters: control of mammalian mitochondrial DNA copy number. J Genet Genom. 2009;36(3):125–31.CrossRef Clay Montier LL, Deng JJ, Bai Y. Number matters: control of mammalian mitochondrial DNA copy number. J Genet Genom. 2009;36(3):125–31.CrossRef
30.
go back to reference Greaves LC, Reeve AK, Taylor RW, Turnbull DM. Mitochondrial DNA and disease. J Pathol. 2012;226(2):274–86.PubMedCrossRef Greaves LC, Reeve AK, Taylor RW, Turnbull DM. Mitochondrial DNA and disease. J Pathol. 2012;226(2):274–86.PubMedCrossRef
31.
go back to reference Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig L, et al. STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies. Clin Chem. 2015;61(12):1446–52.PubMedCrossRef Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig L, et al. STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies. Clin Chem. 2015;61(12):1446–52.PubMedCrossRef
32.
33.
go back to reference Tibshirani R. Regression shrinkage and selection Via the Lasso. J Roy Stat Soc B. 1996;58(1):267. Tibshirani R. Regression shrinkage and selection Via the Lasso. J Roy Stat Soc B. 1996;58(1):267.
34.
go back to reference Robin X, Turck N, Hainard A, Tiberti N, Lisacek F, Sanchez JC, et al. pROC: an open-source package for R and S+ to analyze and compare ROC curves. BMC Bioinformatics. 2011;12:77.PubMedPubMedCentralCrossRef Robin X, Turck N, Hainard A, Tiberti N, Lisacek F, Sanchez JC, et al. pROC: an open-source package for R and S+ to analyze and compare ROC curves. BMC Bioinformatics. 2011;12:77.PubMedPubMedCentralCrossRef
35.
go back to reference Spindler KG, Boysen AK, Pallisgård N, Johansen JS, Tabernero J, Sørensen MM, et al. Cell-free DNA in Metastatic colorectal cancer: a systematic review and meta-analysis. Oncologist. 2017;22(9):1049–55.PubMedPubMedCentralCrossRef Spindler KG, Boysen AK, Pallisgård N, Johansen JS, Tabernero J, Sørensen MM, et al. Cell-free DNA in Metastatic colorectal cancer: a systematic review and meta-analysis. Oncologist. 2017;22(9):1049–55.PubMedPubMedCentralCrossRef
36.
37.
go back to reference Stroun M, Lyautey J, Lederrey C, Mulcahy HE, Anker P. Alu repeat sequences are present in increased proportions compared to a unique gene in plasma/serum DNA: evidence for a preferential release from viable cells? Ann N Y Acad Sci. 2001;945:258–64.PubMedCrossRef Stroun M, Lyautey J, Lederrey C, Mulcahy HE, Anker P. Alu repeat sequences are present in increased proportions compared to a unique gene in plasma/serum DNA: evidence for a preferential release from viable cells? Ann N Y Acad Sci. 2001;945:258–64.PubMedCrossRef
38.
go back to reference Mouliere F, El Messaoudi S, Pang D, Dritschilo A, Thierry AR. Multi-marker analysis of circulating cell-free DNA toward personalized medicine for colorectal cancer. Mol Oncol. 2014;8(5):927–41.PubMedPubMedCentralCrossRef Mouliere F, El Messaoudi S, Pang D, Dritschilo A, Thierry AR. Multi-marker analysis of circulating cell-free DNA toward personalized medicine for colorectal cancer. Mol Oncol. 2014;8(5):927–41.PubMedPubMedCentralCrossRef
39.
go back to reference Jiang P, Chan CW, Chan KC, Cheng SH, Wong J, Wong VW, et al. Lengthening and shortening of plasma DNA in hepatocellular carcinoma patients. Proc Natl Acad Sci USA. 2015;112(11):E1317–25.PubMedPubMedCentralCrossRef Jiang P, Chan CW, Chan KC, Cheng SH, Wong J, Wong VW, et al. Lengthening and shortening of plasma DNA in hepatocellular carcinoma patients. Proc Natl Acad Sci USA. 2015;112(11):E1317–25.PubMedPubMedCentralCrossRef
40.
go back to reference Haupts A, Vogel A, Foersch S, Hartmann M, Maderer A, Wachter N, et al. Comparative analysis of nuclear and mitochondrial DNA from tissue and liquid biopsies of colorectal cancer patients. Sci Rep. 2021;11(1):16745.PubMedPubMedCentralCrossRef Haupts A, Vogel A, Foersch S, Hartmann M, Maderer A, Wachter N, et al. Comparative analysis of nuclear and mitochondrial DNA from tissue and liquid biopsies of colorectal cancer patients. Sci Rep. 2021;11(1):16745.PubMedPubMedCentralCrossRef
41.
go back to reference Al Amir Dache Z, Otandault A, Tanos R, Pastor B, Meddeb R, Sanchez C, et al. Blood contains circulating cell-free respiratory competent mitochondria. FASEB J. 2020;34(3):3616–30.PubMedCrossRef Al Amir Dache Z, Otandault A, Tanos R, Pastor B, Meddeb R, Sanchez C, et al. Blood contains circulating cell-free respiratory competent mitochondria. FASEB J. 2020;34(3):3616–30.PubMedCrossRef
42.
go back to reference Liu Y, Zhou K, Guo S, Wang Y, Ji X, Yuan Q, et al. NGS-based accurate and efficient detection of circulating cell-free mitochondrial DNA in cancer patients. Mol Ther Nucleic Acids. 2021;23:657–66.PubMedPubMedCentralCrossRef Liu Y, Zhou K, Guo S, Wang Y, Ji X, Yuan Q, et al. NGS-based accurate and efficient detection of circulating cell-free mitochondrial DNA in cancer patients. Mol Ther Nucleic Acids. 2021;23:657–66.PubMedPubMedCentralCrossRef
43.
go back to reference Thierry AR, El Messaoudi S, Gahan PB, Anker P, Stroun M. Origins, structures, and functions of circulating DNA in oncology. Cancer Metastasis Rev. 2016;35(3):347–76.PubMedPubMedCentralCrossRef Thierry AR, El Messaoudi S, Gahan PB, Anker P, Stroun M. Origins, structures, and functions of circulating DNA in oncology. Cancer Metastasis Rev. 2016;35(3):347–76.PubMedPubMedCentralCrossRef
44.
go back to reference Nagai Y, Sunami E, Yamamoto Y, Hata K, Okada S, Murono K, et al. LINE-1 hypomethylation status of circulating cell-free DNA in plasma as a biomarker for colorectal cancer. Oncotarget. 2017;8(7):11906–16.PubMedPubMedCentralCrossRef Nagai Y, Sunami E, Yamamoto Y, Hata K, Okada S, Murono K, et al. LINE-1 hypomethylation status of circulating cell-free DNA in plasma as a biomarker for colorectal cancer. Oncotarget. 2017;8(7):11906–16.PubMedPubMedCentralCrossRef
Metadata
Title
Quantification of mitochondrial cfDNA reveals new perspectives for early diagnosis of colorectal cancer
Authors
Christian Linke
Richard Hunger
Mark Reinwald
Markus Deckert
René Mantke
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2023
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-023-10748-y

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