血清TFPI-2基因甲基化在胃癌诊断中的临床价值  

Clinical significance on the detection of serum methylated tissue factor pathway inhibitor 2 gene in the diagnosis of gastric cancer

作　　者：朱立岳[1,2] 关明[3] 康志华[3] 高建萍[1,4] 翁丽贞[1,2] 章励[1,2] 胡雷光[1,2] 

机构地区：[1]上海市静安区中心医院 [2]复旦大学华山医院静安分院检验科,上海200040 [3]复旦大学附属华山医院检验医学科,上海200040 [4]复旦大学华山医院静安分院消化科,上海200040

出　　处：《检验医学》2014年第7期712-717,共6页Laboratory Medicine

基　　金：上海市静安区卫生系统"十;百;千"人才建设工程;专业技术骨干培养资助项目(201006B002)

摘　　要：目的通过测定组织及血清组织因子途径抑制物2(TFPI-2)基因甲基化,探讨其作为一种肿瘤标志物对胃癌诊断的临床价值。方法收集32例胃癌、29例萎缩性胃炎作为研究对象,以30例不排除浅表性胃炎的正常对象作为对照。应用甲基化特异性聚合酶链反应(MSP)方法,测定组织及血清TFPI-2基因甲基化状态。应用电化学发光免疫法测定癌胚抗原(CEA)、糖类抗原199(CA199)。结果组织TFPI-2基因甲基化检出率胃癌组为53.13%、萎缩性胃炎组为37.93%、对照组为3.33%。胃癌组明显高于对照组(P<0.05)。血清TFPI-2基因甲基化检出率胃癌组为28.13%,萎缩性胃炎组为6.90%,对照组未检出。胃癌组明显高于萎缩性胃炎组(P<0.05)和对照组(P<0.05)。血清TFPI-2基因甲基化检测灵敏度为28.13%,特异性为96.61%。血清检出阳性占组织检出阳性的比率为37.93%。胃癌组血清TFPI-2基因甲基化与性别、年龄、Borrmann's分期、CEA和CA199检测结果无关(P>0.05)。胃癌组血清TFPI-2基因甲基化与CEA、CA199阳性检出率分别为28.13%、21.88%、18.75%。联合3项阳性检出率为53.13%,显著高于3项各自单独检测(P<0.05)。结论血清TFPI-2基因甲基化来源于组织,其对胃癌诊断特异性较高,但灵敏度较差。联合检测血清CEA、CA199有利于提高其灵敏度。血清TFPI-2基因甲基化测定对胃癌的诊断有一定价值。Objective Through the detection of serum and tissue methylated tissue factor pathway inhibitor 2（ TFPI-2） gene,to investigate its clinical significance as a tumor marker for the diagnosis of gastric cancer. Methods A total of 32 gastric cancer patients and 29 atrophic gastritis patients were enrolled,and 32 healthy subjects including superficial gastritis were enrolled as control group. Methylated TFPI-2 gene was detected by methylation-specific polymerase chain reaction（ MSP）. Carcinoembryonic antigen（ CEA） and carbohydrate antigen 199（ CA199） were determined by electrochemiluminescence immunoassay. Results The positive rates of methylated TFPI-2 gene in tissue were 53. 13% in gastric cancer group,37. 93% in atrophic gastritis group and 3. 33% in control group. Tissue methylated TFPI-2 gene was significantly higher in gastric cancer group than in control group（ P 0. 05）. The positive rates of methylated TFPI-2 gene in serum were 28. 13% in gastric cancer group,6. 90% in atrophic gastritis group,but none in control group. Serum methylated TFPI-2 gene was significantly higher in gastric cancer group than in atrophic gastritis group（ P 0. 05） and in control group（ P 0. 05）. The sensitivity and specificity of serum methylated TFPI-2gene for the diagnosis of gastric cancer were 28. 13% and 96. 61%. The 37. 93% positive rate was got in serum against tissue. The TFPI-2 gene methylation in serum showed no correlation with sex,age,Borrmann＇ s classification,CEA and CA199 in gastric cancer group（ P 0. 05）. In gastric cancer group,the positive rates of methylated TFPI-2 gene,CEA and CA199 were 28. 13%,21. 88% and 18. 75%,respectively. If performing the combined determination of all the 3parameters,the positive rate was 53. 13%,and the positive rate was significantly higher than those of the single determinations（ P 0. 05）. Conclusions The TFPI-2 gene methylation in serum derives from gastric cancer tissues,and it shows high specificity for the diagnosis of gastric cancer,but the sensit

关 键 词：组织因子途径抑制物-2基因 甲基化 血清游离DNA 胃癌 

分 类 号：R446.11[医药卫生—诊断学]