Evaluation of FOXF1 promoter DNA methylation, as a promising epigenetic biomarker for colorectal cancer in stool samples

Background: Colorectal cancer (CRC) pathogenesis is influenced by genes promoter region methylation, a key epigenetic mechanism. We sought to determine whether FOXF1 promoter methylation in stool samples could serve as a CRC biomarker. Materials and methods: We analyzed FOXF1 gene promoter methylation in stool samples from 50 CRC patients and 50 healthy controls. The percentage of methylation reference (PMR) value was determined for each sample. Results: PMR levels of the FOXF1 gene were higher in CRC patients than in controls (P<0.001). Median PMR values were 0.06 (95% CI 0.01-13.1) in stool samples from CRC patients and 0.01 (95% CI 0.0-0.02) in controls. Receiver Operating Characteristics (ROC) Curve analysis displayed a sensitivity of 59% and specificity 96% for FOXF1 gene methylation in stool samples. Conclusion: The elevated FOXF1 methylation levels in CRC stool samples, along with the test's sensitivity and specificity, suggest that this gene may be utilized as a non-invasive biomarker for colorectal cancer detection, independent of sex, age, or disease stage.