联合检测Septin9与SDC2和TFPI2甲基化及粪便隐血在大肠病变筛查中的临床应用  

Evaluation of Septin9,SDC2,TFPI2 methylation and fecal occult blood in the screening of large intestine lesions

作　　者：李海军[1] 牛春梅[1] 任静[1] 赵诤[1] Li Haijun;Niu Chunmei;Ren Jing;Zhao Zheng(Laboratory Department,Guangyuan Central Hospital,Guangyuan 628000,China)

机构地区：[1]四川省广元市中心医院检验科,广元市628000

出　　处：《中华检验医学杂志》2020年第4期482-488,共7页Chinese Journal of Laboratory Medicine

基　　金：广元市重点研发项目(2017ZCZDYF007)。

摘　　要：目的:探讨外周血Septin9基因甲基化联合测定粪便样本中硫酸类肝素蛋白多糖基因(syndecan-2,SDC2)甲基化和组织因子途径抑制物2(tissue factor pathway inhibitor 2,TFPI2)基因甲基化与粪便隐血试验(fecal occult blood test,FOBT)在大肠病变筛查中的临床价值。方法:选取2017年1月至2019年6月期间于四川省广元市中心医院治疗的75例大肠癌患者和50例进展期腺瘤患者分别作为大肠癌组和进展期腺瘤组,并以同期40例结肠镜检查结果为阴性者作为对照组,采用甲基化特异性PCR(MSP)法检测全部3组受试者外周血Septin9、SDC2和TFPI2基因甲基化状态以及粪便隐血试验筛查大肠癌和进展期腺瘤。绘制受试者工作特征曲线(receiver operating characteristic curve,ROC),比较联合检测与各指标单独检测的诊断价值。结果:大肠癌组Septin9、SDC2、TFPI2基因甲基化、FOBT的阳性检出率分别为53.04%(61/115例)、55.65%(64/115例)、59.13%(68/115例)、26.09%(30/115例),进展期腺瘤组Septin9、SDC2、TFPI2基因甲基化、FOBT的阳性检出率分别为33.33%(30/90例)、50.00%(45/90例)、40.00%(36/90例)、17.78%(16/90例)。以病理学检查判断为金标准,Septin9、SDC2、TFPI2基因甲基化联合检查筛查大肠癌时检测敏感度(82.7%)高于各单项检查以及SDC2和TFPI2基因甲基化联合检测敏感度[Septin9基因甲基化(66.7%)、SDC2基因甲基化(69.3%)、TFPI2基因甲基化(73.3%)、FOBT(26.7%)、SDC2和TFPI2基因甲基化联合检测(77.3%)],同时还保持了较高的特异度(80.0%)。Septin9、SDC2、TFPI2基因甲基化联合检查筛查进展期腺瘤检测敏感度(70.0%)高于各单项检查以及SDC2和TFPI2基因甲基化联合检测敏感度[Septin9基因甲基化(40.0%)、SDC2基因甲基化(64.0%)、TFPI2基因甲基化(50.0%)、FOBT(18.0%)、SDC2和TFPI2基因甲基化联合检测(64.0%)],也保持了较高的特异度(82.5%)。ROC曲线分析结果显示3种基因甲基化联合检查筛查大肠癌时的ROC曲Objective To investigate the clinical application value of peripheral blood methylation Septin9 gene in peripheral blood combined with SDC2 gene methylation and TFPI2 gene methylation and fecal occult blood test in colorectal lesion screening.Methods Through random-selection method.Seventy-five patients with colorectal cancer and 50 patients with advanced adenoma who were treated in our hospital from January 2017 to June 2019 were enrolled as the colorectal cancer group and the advanced adenocarcinoma group,respectively,and the results of the negative test were used as controls Methylation-specific PCR(MSP)was used to detect the methylation status of the Septin9,SDC2 and TFPI2 genes in all patients and the fecal occult blood test for colorectal cancer and advanced adenocarcinoma.In addition,the receiver operating characteristic curve(ROC curve)was drawn to compare the diagnostic value of combined detection and individual detection.Results The positive rate of Septin9,SDC2,TFPI2 methylation and FOBT in colorectal cancer group was 53.04%(61/115 cases),55.65%(64/115 cases),59.13%(68/115 cases)and 26.09%(30/115 cases),respectively.The positive detection rates of Septin9,SDC2,TFPI2 methylation and FOBT in the advanced adenoma group were 33.33%(30/90 cases),50%(45/90 cases),40.00%(36/90 cases)and 17.78%(16/90 cases),respectively.The detection sensitivity(82.7%)was higher than the sensitivity of each single test and combined detection of SDC2 and TFPI2 gene methylation:Septin9 methylation(66.7%),SDC2 methylation(69.3%),TFPI2 methylation(73.3%),FOBT(26.7%),SDC2 and TFPI2 methylation combined detection(77.3%),while maintaining a high specificity(80.0%).Septin9,SDC2,TFPI2 gene methylation joint inspection screening advanced adenomas detection sensitivity(70.0%)was higher than the sensitivity of each single test and combined detection of SDC2 and TFPI2 gene methylation:(40.0%),SDC2 Septin9 gene methylation gene methylation(64.0%),TFPI2 methylation(50.0%),FOBT(18.0%),SDC2 and TFPI2 gene methylation detection(64.0%),and also

关 键 词：大肠癌 甲基化 粪便隐血 联合检测 

分 类 号：R735[医药卫生—肿瘤] R57[医药卫生—临床医学]