结直肠癌粪便样本KRAS突变检测的诊断价值  

Diagnostic Value of KRAS Mutation Detection by Stool Samples of Colorectal Cancer

作　　者：李瑞斌[1] 柳麒 唐蒙 石莹莹 厉娜 周福祥[1] 王文博[1] Li Ruibin;Liu Qi;Tang Meng(GI Cancer Division Department of Radiation ＆ Medical Oncology, Zhongnan Hospital of Wuhan University, Key Lab of Hubei Province on Tumor Biological Behavior,Wuhan 430071 ,China)

机构地区：[1]武汉大学中南医院胃肠肿瘤放化疗科、肿瘤生物学行为湖北省重点实验室,湖北武汉430071

出　　处：《医学新知》2018年第2期143-146,共4页New Medicine

摘　　要：目的 评价检测结直肠癌患者粪便样本KRAS突变的临床价值.方法 收集2016年10月至2017年12月确诊为结直肠癌患者术前的粪便样本,利用实时荧光定量PCR方法检测KRAS突变;收集患者KRAS突变检测的分子病理结果 作为＂金标准＂,计算粪便样本检测的灵敏度、特异度等指标,评价粪便样本检测KRAS突变的诊断价值.结果粪便样本检测为KRAS突变的有17例,突变率为56.7％（17/30）.粪便样本检测KRAS突变的灵敏度为91.7％,阳性预测值为64.7％;对KRAS突变阴性人群的特异度为66.7％、阴性预测值为92.3％.结论 结直肠癌粪便样本检测KRAS突变具有较高的灵敏度和阴性预测值,可用于辅助诊断KRAS突变阴性的患者及无法获取组织标本的结直肠癌患者.Objective To evaluate the clinical value of detecting KRAS mutations by stool samples from patients with colorectal cancer. Methods Stool samples from patients with colorectal cancer diagnosed in our hospital from October 2016 to December 2017 were collected, the KRAS mutation was detected by real-time fluorescence quantitative PCR. The molecular pathologic results of KRAS mutation regarded as the ＂gold standard＂ were collected to calculate the sensitivity, the specificity and other indexes of KRAS mutations detection by stool samples. Results There were 17 stool samples with mutation in KRAS and the mutation rate was 56.7% （17/30）. The sensitivity of detecting KRAS mutation by stool samples was 91.7% and the positive predictive value was 64.7%. Meanwhile, the specificity was 66.7% and the negative predictive value reached 92.3%. Conclusions Detecting KRAS mutations by stool samples made the inspiring performance in the sensitivity and the negative predictive value, which could be applied to auxiliarily diagnose patients without KRAS mutations or unable to obtain tissue samples.

关 键 词：结直肠癌 KRAS基因突变 粪便样本 灵敏度 阴性预测值 

分 类 号：R735.34[医药卫生—肿瘤]