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Diagnostics
Special Issues
Innovations in Colorectal Cancer Detection and Diagnosis
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Innovations in Colorectal Cancer Detection and Diagnosis

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: 31 July 2026 | Viewed by 858

Special Issue Editor

Dr. Wei Xin

E-Mail Website
Guest Editor
Department of Pathology, University of South Alabama College of Medicine, Mobile, AL, USA
Interests: colon adenocarcinomas; pathology

Special Issue Information

Dear Colleagues,

Colorectal cancer (CRC) remains a leading cause of cancer-related morbidity and mortality worldwide, despite significant advances in screening and therapy. Early detection and accurate diagnosis are critical determinants of patient outcomes, directly influencing treatment selection, prognostication, and survival. Traditional screening and diagnostic approaches, such as colonoscopy, histopathologic evaluation, and conventional imaging, have substantially reduced CRC mortality, but important gaps remain, particularly in detecting early lesions, high-risk precursor lesions, and biologically aggressive tumor subtypes.

Recent years have witnessed rapid innovation across multiple domains of CRC detection and diagnosis. Advances in molecular pathology, including microsatellite instability (MSI) testing, mismatch repair (MMR) assessment, next-generation sequencing (NGS), and liquid biopsy technologies, are reshaping diagnostic algorithms and enabling precision oncology. Parallel progress in digital pathology and artificial intelligence (AI) has introduced new tools for automated polyp detection, tumor grading, biomarker quantification, and risk stratification, with the potential to improve diagnostic accuracy, efficiency, and reproducibility. In addition, novel imaging modalities, stool and blood-based biomarkers, microbiome profiling, and multi-omics integration are expanding opportunities for noninvasive and population-level screening.

This Special Issue aims to provide a comprehensive platform for original research, reviews, and translational studies that highlight emerging technologies, methodologies, and clinical applications in CRC detection and diagnosis. We welcome contributions spanning basic science, translational research, clinical validation, and implementation science, with an emphasis on innovations that improve early detection, refine diagnostic precision, and support personalized patient care. By bringing together multidisciplinary perspectives from pathology, gastroenterology, oncology, bioinformatics, and biomedical engineering, this collection seeks to inform current practice and shape future directions in colorectal cancer diagnostics.

Dr. Wei Xin
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • colorectal cancer
  • early detection
  • diagnostic pathology
  • molecular biomarkers
  • microsatellite instability
  • next-generation sequencing
  • liquid biopsy
  • digital pathology
  • artificial intelligence
  • precision oncology

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

13 pages, 2163 KB  
Article
SMAD4 Protein Alterations in Early-Onset Colorectal Cancer: Implications as a Potential Marker for Aggressive Disease and Prognosis—A Clinicopathological and Molecular Analysis of 18 Cases in Patients < 40 Years of Age
by Lingling Xian, Jim Lu, Lan Zhou and Wei Xin
Diagnostics 2026, 16(12), 1804; https://doi.org/10.3390/diagnostics16121804 - 11 Jun 2026
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Abstract
Background/Objectives: Colorectal cancer (CRC) is relatively uncommon in individuals under 40 years of age; however, its rising incidence is a growing concern. This study aimed to investigate clinicopathologic features, genetic alterations, and protein expression patterns in early-onset colorectal cancer (EOCRC) to better understand [...] Read more.
Background/Objectives: Colorectal cancer (CRC) is relatively uncommon in individuals under 40 years of age; however, its rising incidence is a growing concern. This study aimed to investigate clinicopathologic features, genetic alterations, and protein expression patterns in early-onset colorectal cancer (EOCRC) to better understand the underlying mechanisms and prognostic factors. Methods: We retrospectively analyzed 18 patients diagnosed with EOCRC (<40 years) at our institution between 2018 and 2023. Next-generation sequencing (NGS) and immunohistochemistry (IHC) were used to assess genomic alterations and protein expression profiles. Clinicopathologic data were correlated with molecular findings and outcomes. Results: The cohort included ten females and eight males (mean age, 32.7 years; range, 17–38 years). Tumors most frequently arose in the rectum (56%) and were predominantly high stage (T3–T4, 67%) and moderately differentiated (78%). Lymphovascular invasion occurred in 50% of cases, and lymph node metastasis in 39%. Most tumors were microsatellite stable (MSS, 89%) and mismatch repair–proficient; two cases (11%) were MSI-high with germline MMR mutations. Among 17 patients who underwent NGS, the most frequent mutations involved KRAS (35%), APC (24%), TP53 (18%), and SMAD4 (18%). Notably, SMAD4 protein downregulation by IHC was observed in 67% of cases, including 60% of SMAD4 wild-type tumors. Loss of SMAD4 expression was significantly associated with lymph node metastasis (p = 0.037) and poor survival (p = 0.045). Conclusions: SMAD4 alteration—on both the genetic and protein levels—is common in EOCRC and is significantly correlated with aggressive clinicopathologic features and worse prognosis. Full article
(This article belongs to the Special Issue Innovations in Colorectal Cancer Detection and Diagnosis)
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33 pages, 9452 KB  
Article
RFID Technology for Intraoperative Localisation of Small Colorectal Tumours: Electromagnetic Analysis and Experimental Validation
by Bogdan Mocan, Mihaela Mocan, Mircea Fulea, Mircea Murar, Zsolt Mate, Adrian Calborean and Vasile Virgil Bintintan
Diagnostics 2026, 16(9), 1318; https://doi.org/10.3390/diagnostics16091318 - 28 Apr 2026
Viewed by 513
Abstract
Background/Objectives: Accurate intraoperative tumour localisation remains challenging in minimally invasive colorectal surgery, where conventional tattooing methods suffer from marker migration, tissue diffusion, and potential allergic reactions. Radio frequency identification (RFID) technology offers a promising alternative through implantable passive transponders detectable via electromagnetic [...] Read more.
Background/Objectives: Accurate intraoperative tumour localisation remains challenging in minimally invasive colorectal surgery, where conventional tattooing methods suffer from marker migration, tissue diffusion, and potential allergic reactions. Radio frequency identification (RFID) technology offers a promising alternative through implantable passive transponders detectable via electromagnetic coupling, eliminating ionising radiation exposure. Methods: This preclinical feasibility study evaluated three RFID frequency bands for surgical tumour marking: 134 kHz (low frequency, LF), 13.56 MHz (high frequency, HF), and 868 MHz (ultra-high frequency, UHF). Finite element electromagnetic simulations characterised antenna field distributions, while experimental validation employed glass-encapsulated transponders in air and tissue-simulating saline (0.9% NaCl, σ ≈ 1.5 S/m). Detection ranges were measured across 28 angular configurations with expanded measurement uncertainty (k = 2) ranging from ±0.9 to ±3.2 mm. Results: Maximum detection distances in air were 25.0 ± 0.9 mm (LF), 23.0 ± 1.1 mm (HF), and 68.0 ± 2.3 mm (UHF). In saline, ranges decreased to 22.5 ± 1.0 mm, 20.7 ± 1.2 mm, and 18.0 ± 1.4 mm, respectively, demonstrating tissue attenuation of 10% at LF/HF vs. 74% at UHF. Angular characterisation revealed 64–70% range reduction at orthogonal orientation for LF/HF systems. Computational–experimental correlation yielded r2 = 0.975 across 154 paired observations. Conclusions: The 13.56 MHz HF band emerges as the optimal candidate for clinical translation, offering adequate tissue penetration (20.7 mm), superior antenna miniaturisation potential (5 mm diameter), established biocompatibility pathways, and mature near-field communication ecosystem support. Future development should address angular sensitivity through multi-axis antenna configurations and validation in anatomically realistic tissue phantoms. This study establishes the electromagnetic evidence base for clinical system development; translation to clinical practice requires sequential preclinical and clinical evaluation. Full article
(This article belongs to the Special Issue Innovations in Colorectal Cancer Detection and Diagnosis)
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