All six biomarkers were significantly up-regulated in CRC as compared with the control samples. The data were also CT99021 research buy evaluated using Mann-Whitney independent sample rank sum tests, and the results were highly statistically significant in both the North American and Malaysian studies (p < 0.0005). Figure 1 Comparison of the Expression of Six Genes of PD0332991 cost Interest (ANXA2, CLEC4D, LMNB1, PRRG4, TNFAIP6 and VNN1) in CRC (N = 99) and Controls (N = 101) as shown in Raw Ct-values. (Error bars denote Standard Errors of the Mean) All six biomarkers are shown as up-regulated genes in CRC as compared with controls. Figure 2 Comparison of the Expression of Partner or Reference Gene (IL2RB) for the corresponding

six biomarkers (numbered from 1 to 6) in CRC (N = 99) and Controls (N = 101). The figure shows the reference gene as down-regulated as compared with control samples. Table 4 Expression

of Gene Biomarkers in North American and Malaysian Samples Symbol Parameter ANXA3 CLEC4D LMNB1 PRRG4 TNFAIP6 VNN1 North Fold Change 1.71 1.50 1.37 1.72 1.58 1.53 American p-Value < 0.0001 < 0.0001 < 0.0001 < 0.0001 < 0.0001 < 0.0001 Malaysian Fold Change 2.06 1.75 1.65 1.37 1.80 1.87   p-Value < 0.0001 < 0.0001 < 0.0001 < 0.0003 < 0.0001 < 0.0001 Note: North American selleckchem Training Set comprises 112 CRC and 120 control samples. Malaysian Study Set comprises 99 CRC and 111 control samples. The significance of the fold changes were evaluated using Mann-Whitney independent sample rank sum tests. The performance characteristics of the Malaysian samples were demonstrated by logistic regression multivariate analysis. For the comparison study with the data obtained in North America, a common classification table cutoff or threshold value was set (P = 0.5) for the logistic regression analysis. The performance characteristics yielded a specificity of 77%, a sensitivity of 61%, accuracy of 70%, and the area under the curve (AUC) of the 4��8C Receiver Operating Characteristic (ROC)

was 0.76 (95% Confidence Interval: 0.70 to 0.82). These results are comparable to data obtained from the North American samples and are presented in Table 5. Table 5 Comparison on Logistic Regression Analyses between North American and Malaysian Samples. Study Location North American Malaysian   Training Set Test Set   Sample Size 232 410 210 CRC 112 202 99 Control 120 208 111 Cut-off Value P = 0.5 P = 0.5 P = 0.5 Area under ROC Curve (95% CI) 0.80 (0.74 – 0.85) 0.80 (0.76 – 0.84) 0.76 (0.70 – 0.82) Significant Level P < 0.0001 P < 0.0001 P < 0.0001 Sensitivity 82% 72% 61% Specificity 64% 70% 77% Accuracy 73% 71% 70% Note: The MedCalc software, version 11.3 (Broekstraat 52, Mariakerke, Belgium) was used for the statistical analysis. CI denotes confidence interval. The gene expression levels are continuous variables, which makes it possible to define a threshold for optimum sensitivity and specificity that is best suited for the intended application.