联合检测粪隐血试验与粪便DNA在大肠癌机会性筛查中的探讨  

Investigation of Combined Detection of Fecal Occult Blood Test and Fecal DNA Test in the Opportunity Screening for Colorectal Cancer

作　　者：钟选芳[1] 甘爱华[1] 张晓慧[1] 许岸高[1] 肖丹[1] 

机构地区：[1]惠州市第一人民医院消化内科,广东惠州516001

出　　处：《肿瘤基础与临床》2015年第6期508-511,共4页journal of basic and clinical oncology

基　　金：广东省医学科学技术研究基金资助项目(编号:B2011340)

摘　　要：目的探讨联合检测粪隐血试验与粪便DNA用于大肠癌机会性筛查的应用和意义。方法入组行机会性筛查的46例大肠癌患者和30例正常者的粪便,分别应用免疫法粪便隐血试验(IFOBT)2次,应用PCR-SSCP方法检测粪便中APC、P53和K-ras基因突变情况。结果大肠癌组和正常组粪便IFOBT的阳性率分别为45.7%(21/46)和13.3%(4/30),APC、P53、K-ras的突变率分别为58.7%(27/46)、65.2%(30/46)、60.9%(28/46)和3.3%(1/30)、0.0%(0/30)、0.0%(0/30),IFOBT和粪便DNA筛查大肠癌的敏感性和特异性差异无统计学意义,两者联合检测的敏感性高于任何一种单独检测方法。结论联合检测粪隐血试验和粪便DNA可提高大肠癌筛查效率,有望成为一种有效的无创的大肠癌早期诊断和筛查方法,可用于机会性筛查。Objective To investigate the application and significance of opportunistic screening for colorectal cancer using combined detection of fecal occult blood test and fecal DNA test. Methods Forty-six patients with colorectal cancer and 30 normal volunteers were given with opportunistic screening, and were tested using immunochemical fecal occult blood tests（IFOBT） , as well as the APC, P53 and K-ras mutations in the feces were detected by using polymerase chain reaction single strand conformation polymorphism（PCR-SSCP）. Results The positive rate of IFOBT was 45.7% （21/46）and 13.3% （4/30）in the colorectal cancer group and the normal group, respectively. Meanwhile, the mutation rate of APC, P53, K-ras genes in the colorectal cancer group were 58.7 % （27/46） , 65.2% （30/46） and 60.9% （ 28/46 ） ; and were 3.3% （ 1/30 ）, 0.0% （ 0/30 ） and 0.0% （ 0/30 ） in the normal group. There was no significant difference in the sensitivity and specificity between IFOBT and fecal DNA screening of colorectal cancer, and the sensitivity of joint detection was higher than any single detection method. Conclusion The combined detection of fecal occult blood test and fecal DNA can raise the efficacy of the colorectal cancer screening,it can be used to become an effective noninvasive method of colorectal cancer in the opportunistic screening of early diagnosis and screening.

关 键 词：粪隐血试验 粪便DNA 大肠癌 机会性筛查 

分 类 号：R735.34[医药卫生—肿瘤] R730.1[医药卫生—临床医学]