粪便DNA与粪隐血试验机会性筛查大肠肿瘤的比较研究  

Fecal DNA versus fecal occult blood test in opportunity screening for colorectal neoplasm

作　　者：钟选芳[1] 肖丹[1] 许岸高[1] 甘爱华[1] 张晓慧[1] 余中贵[1] 黄文峰[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：《临床消化病杂志》2016年第2期106-109,共4页Chinese Journal of Clinical Gastroenterology

基　　金：广东省医学科学技术研究基金项目(No:B2011340)

摘　　要：[目的]探讨粪便DNA检测在大肠肿瘤机会性筛查中的价值。[方法]进入筛查的人群中连续收集46例大肠癌(CRC)、60例大肠腺瘤(CRA)及30例正常粪便标本,采用PCR-SSCP银染法检测粪便DNA突变情况,并与免疫法粪便隐血试验(IFOBT)比较。[结果]CRC组、CRA组和正常组IFOBT的阳性率分别为45.7%(21/46)、18.3%(11/60)和13.33%(4/30);CRC组、CRA组和正常组APC的突变率分别为58.7%(27/46)、20.0%(12/60)和3.33%(1/30),p53的突变率分别为65.2%(30/46)、25.0%(15/60)和0%(0/30),K-ras的突变率分别为60.9%(28/46)、23.3%(14/60)和0%(0/30),粪便DNA 3个基因联合检测的突变率分别为76.1%(35/46)、35.0%(21/60)和3.33%(1/30)。CRC组、CRA组中APC、p53、K-ras基因单独检测的敏感性与IFOBT比较,差异均无统计学意义(P>0.05);CRC组、CRA组粪便DNA 3个基因联合检测的敏感性均高于IFOBT,差异有统计学意义(P<0.05);CRC组、CRA组粪便DNA 3个基因单独和联合检测大肠肿瘤的特异性均高于IFOBT,但均差异无统计学意义(P>0.05)。[结论]粪便DNA联合检测大肠肿瘤的敏感性高于IFOBT,提示粪便DNA检测可能是更适于机会性筛查大肠肿瘤的无创性筛查方法。[Objective]Explore the value of fecal DNA in opportunity screening of colorectal neoplasm. [Methods]Samples were enrolled from Gastroenterology Clinic in Huizhou first People hospital from 2011- 11 to 2012-08,including 46 colorectal cancer stool specimens,60 colorectal adenoma stool specimens and 30 normal stool specimens. The stool specimens were collected and the APC,p53,K-ras mutations were detec-ted by using the PCR-SSCP silver staining. I-Results]The mutation rates of APC,p53,K-ras in CRC group were58.7%（27/46）,65.2% （30/46）and 60.90%（28/46）. However,it was 20.0%（12/60）,25.0%（15/60） and 23.3%（14/60）in CRA group,and 3.33%（1/30）,0%（0/30） and 0%（0/30）in normal group. The posi- tive rates of IFOBT inCRC,CRA and normal group were 45.7% （21/46）,18.3% （11/60）and 13.33%（4/ 30）respectively. There was no significantly difference between CRC and CRA group of solo gene detection （P〈0.05）. However the sensitivity of three genes detection was significantly higher than IFOBT between CRC and CRA（P〈0.05）;the specificity of solo or three genes detection in CRC and CRA group were higher than IFOBT, but there was no significantly difference （P 〈0. 05）. [-Conclusion] The sensitivity of multiple gene mutations detection in feces of colorectal neoplasm is higher than IFOBT in opportunity screening, which suggests that fecal DNA detecting maybe a more suitable non-invasive method for colorec- tal neoplasia screening.

关 键 词：粪便DNA检测 免疫法粪便隐血试验 大肠肿瘤 机会性筛查 

分 类 号：R735.34[医药卫生—肿瘤]