Septin-9: a novel biomarker for colorectal cancer screening

Alp Yildiz, Huseyin Gobut, Sezai Leventoglu, Aybala Yildiz, Mehmet Ali Ergun, Ayhan Kubar, Bulent Aytac


Background: The gold standard method for the diagnosis of colorectal cancer is colonoscopy. However, colonoscopy has several limitations and complications. Moreover, fecal occult blood test and serum based tumor markers do lack the desired specificity and sensitivity. Therefore, a novel biomarker is needed for early detection of colorectal cancer. With this prospective randomised controlled study author’s aim was to evaluate the efficacy of Septin-9 on colorectal cancer screening.

Methods: Septin-9 is a protein which is encoded by the SEPT9 gene. SEPT9 has been detected in the blood of colorectal cancer patients. In this study, the results of fecal occult blood test, carcinoembryonic antigen and SEPT9 using fecal and blood samples of the patients obtained before colonoscopy were compared. DNA isolation and bisulfite transformation were made from the blood samples for SEPT9. The experimental and control groups were built up using the results of biopsy taken during colonoscopy.

Results: Fecal occult blood test was determined as positive in control group for 30% (6/20), in colorectal cancer group for 54.2% (13/24). FOBT specificity and sensitivity for colorectal cancer were 54.1%, 70%, respectively. Sensitivity and specificity of Septin9 at detecting colorectal cancers were found statistically significant according to either fecal occult blood test or carcinoembryonic antigen values.

Conclusions: When author evaluated their situation in the light of the data, it was seen that CRCs is an important public health problem. As being an easily applicable test by blood sample and having high sensitivity and specificity, SEPT9 should take its place in routine screening protocols.


Cancer screening, Colorectal cancer, Septin-9

Full Text:



Jemal A, Thomas A, Murray T, Thun M. Cancer statistics, 2002. Cancer J Clin. 2002;52(1):23-47.

Reinier G.S. Meester, MS. Erasmus MC University Medical Center, Rotterdam, the Netherlands. Public health impact of achieving 80% colorectal cancer screening rates in the United States by 2018. Cancer: Guideline Am Cancer Soc, 2015.

Sandrock K, Bartsch I, Bläser S, Busse A, Busse E, Zieger B. Characterization of human septin interactions. Biol Chem. 2011;392(8-9):751-61.

Jemal A, Thomas A, Murray T, Thun M. Cancer statistics, 2002. Cancer J Clin. 2002;52(1):23-47.

Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. Cancer J Clin. 2015;65(1):5-29.

Ahlquist DA. Molecular detection of colorectal neoplasia. Gastroenterol. 2010;138(6):2127-39.

Tóth K, Sipos F, Kalmár A, Patai ÁV, Wichmann B, Stoehr R, et al. Detection of methylated SEPT9 in plasma is a reliable screening method for both left-and right-sided colon cancers. PloS One. 2012;7(9):e46000.

Newton KF, Newman W, Hill J. Review of biomarkers in colorectal cancer. Colorectal Dis. 2012;14(1):3-17.

Burch JA, Soares-Weiser K, St John DJ, Duffy S, Smith S, Kleijnen J, et al. Diagnostic accuracy of faecal occult blood tests used in screening for colorectal cancer: a systematic review. J Med Screening. 2007;14(3):132-7.

Lofton-Day C, Model F, DeVos T, Tetzner R, Distler J, Schuster M, et al. DNA methylation biomarkers for blood-based colorectal cancer screening. Clin Chem. 2008;54(2):414-23.

Kronborg O, Fenger C, Olsen J, Jørgensen OD, Søndergaard O. Randomised study of screening for colorectal cancer with faecal-occult-blood test. Lancet. 1996;348(9040):1467-71.

Allison JE, Sakoda LC, Levin TR, Tucker JP, Tekawa IS, Cuff T, et al. Screening for colorectal neoplasms with new fecal occult blood tests: update on performance characteristics. J National Cancer Inst. 2007;99(19):1462-70.

Rossum LG, Rijn AF, Oijen MG, Fockens P, Laheij RJ, Verbeek AL, et al. False negative fecal occult blood tests due to delayed sample return in colorectal cancer screening. Inter J Cancer. 2009;125(4):746-50.

Nawa T, Kato J, Kawamoto H, Okada H, Yamamoto H, Kohno H, et al. Differences between right‐and left‐sided colon cancer in patient characteristics, cancer morphology and histology. J Gastroenterol Hepatol. 2008;23(3):418-23.

Scott M, McCluggage WG, Hillan KJ, Hall PA, Russell SH. Altered patterns of transcription of the septin gene, SEPT9, in ovarian tumorigenesis. Inter J Cancer. 2006;118(5):1325-9.

Grützmann R, Molnar B, Pilarsky C, Habermann JK, Schlag PM, Saeger HD, et al. Sensitive detection of colorectal cancer in peripheral blood by Septin9 DNA methylation assay. PloS One. 2008;3(11):e3759.