外周血及痰液SHOX2、RASSF1A基因甲基化检测对肺癌早期诊断的意义  

Significance of detection of SHOX2 and RASSF1A gene methylation in peripheral blood and sputum for early diagnosis of lung cancer

作　　者：孙永强[1] 孔天东[2] 段方方[2] 陈露[2] 周寒丽[2] 刘萌萌[3] 吴书一[4] Sun Yongqiang;Kong Tiandong;Duan Fangfang;Chen Lu;Zhou Hanli;Liu Mengmeng;Wu Shuyi(Department of Oncological Surgery,the Third People’s Hospital of Zhengzhou,Zhengzhou Tumor Hospital of Henan University,Zhengzhou 450000,China;Department of Medical Oncology,the Third People’s Hospital of Zhengzhou,Zhengzhou Tumor Hospital of Henan University,Zhengzhou 450000,China;Department of Pathology,the Third People’s Hospital of Zhengzhou,Zhengzhou Tumor Hospital of Henan University,Zhengzhou Tumor Hospital of Henan University,Zhengzhou 450000,China;Department of Central Lab,the Third People’s Hospital of Zhengzhou,Zhengzhou Tumor Hospital of Henan University,Zhengzhou 450000,China)

机构地区：[1]郑州市第三人民医院,河南大学附属肿瘤医院肿瘤外科,450000 [2]郑州市第三人民医院,河南大学附属肿瘤医院肿瘤内科,450000 [3]郑州市第三人民医院,河南大学附属肿瘤医院病理科,450000 [4]郑州市第三人民医院,河南大学附属肿瘤医院中心实验室,450000

出　　处：《中国实用医刊》2020年第8期9-12,共4页Chinese Journal of Practical Medicine

基　　金：河南省医学科技攻关重点项目(201302028)。

摘　　要：目的明确外周血及痰液矮小同源盒基因2(SHOX2)、RAS相关区域家族1A(RASSF1A)基因甲基化检测对肺癌早期诊断的意义。方法抽取2018年3月至2019年3月郑州市第三人民医院收治的120例肺癌患者作为观察组,同时选取医院60例健康成年体检者为对照组。采集所有受试者外周血及痰液标本,采用实时荧光PCR检测SHOX2、RASSF1A基因甲基化的阳性率,并比较外周血及痰液联合进行SHOX2、RASSF1A基因甲基化检测诊断肺癌的敏感性。结果观察组、对照组患者血液SHOX2基因甲基化检测阳性率分别为44.17%、5.00%,痰液为61.67%、6.67%,血液或痰液任一阳性率分别为77.50%、11.67%,差异均有统计学意义(P<0.05);观察组与对照组RASSF1A基因甲基化检测在血液中的阳性率分别为39.17%、3.33%,痰液中的阳性率分别为45.00%、5.00%,血液或痰液任一阳性率分别为50.00%、8.33%,差异有统计学意义(P<0.05)。SHOX2、RASSF1A基因启动子甲基化外周血、痰液以并联方式联合检测(任一项阳性),其灵敏度为96.67%、准确度为93.33%、阴性预测值为92.86%,均较单项检测有明显提高,差异有统计学意义(P<0.05)。结论血液、痰液SHOX2、RASSF1A基因甲基化联合检测取材方便快捷,且较单一基因甲基化检测灵敏度更高,特异度不受影响,是一种理想的肺癌早期诊断方法。Objective To clarify the significance of short stature homobox 2(SHOX2)and RAS association domain family1A(RASSF1A)gene methylation detection in peripheral blood and sputum for early diagnosis of lung cancer.Methods A total of 120 patients with lung cancer from March 2018 to March 2019 in the Third People's Hospital of Zhengzhou were selected as observation group,and 60 healthy adults were selected as control group.The positive rates of SHOX2 and RASSF1A gene methylation were detected by real-time fluorescent PCR in peripheral blood and sputum samples of all subjects.The sensitivity of SHOX2 and RASSF1A gene methylation detection in peripheral blood and sputum for diagnosis of lung cancer was compared.Results The positive rates of SHOX2 gene methylation in blood,sputum,blood or sputum were 44.17%vs.5.00%,61.67%vs.6.67%,and 77.50%vs.11.67%respectively in observation group and control group(P<0.05).The positive rates of RASSF1A gene methylation in blood,sputum,blood and sputum were 39.17%and 3.33%respectively,45.00%and 5.00%respectively,50.00%and 8.33%respectively in observation group and control group,with significant differences(P<0.05).The sensitivity,accuracy and negative predictive value of SHOX2 and RASSF1A promoter methylation in peripheral blood and sputum were 96.67%,93.33%and 92.86%respectively,which were significantly higher than those of single detection(P<0.05).Conclusions The combination detection of SHOX2 and RASSF1A gene methylation in blood and sputum was an ideal method for early diagnosis of lung cancer.

关 键 词：肺癌 甲基化 矮小同源盒基因2 RAS相关区域家族1A 

分 类 号：R734[医药卫生—肿瘤]