血浆Septin9甲基化在肝癌鉴别诊断中的临床价值  

The clinical value of Septin9 methylation in the differential diagnosis of liver cancer

作　　者：沈志明 冯杰[2] 魏静 颜光涛[2] SHEN Zhiming;FENG Jie;WEI Jing;YAN Guangtao(Department of Clinical Laboratory,the First Affiliated Hospital of Gannan Medical College,Ganzhou,Jiangxi 341000,China;Medical Laboratory Center,PLA General Hospital,Beijing 100853,China)

机构地区：[1]赣南医学院第一附属医院检验科,江西赣州341000 [2]解放军总医院医学检验中心,北京100853

出　　处：《国际检验医学杂志》2020年第23期2831-2834,2838,共5页International Journal of Laboratory Medicine

基　　金：国家科技支撑计划项目(2015BAK45B01)。

摘　　要：目的探究血浆Septin9甲基化在原发性肝癌(简称肝癌)鉴别诊断中的临床价值。方法选取2018年11月至2019年11月在解放军总医院确诊的原发性肝细胞癌患者175例、胆管细胞癌患者101例和同期体检健康者163例的临床资料,分别作为肝细胞癌组、胆管细胞癌组和健康对照组,对3组肝功能、肿瘤标志物和血浆Septin9甲基化指标进行比较。结果肝细胞癌组Septin9甲基化阳性表达率[61.7%(108/175)]高于胆管细胞癌组Septin9甲基化阳性表达率[39.6%(40/101)]和健康对照组(0.0%),差异有统计学意义(P<0.05)。胆管细胞癌组糖类抗原199、糖类抗原125、糖类抗原153、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、碱性磷酸酶、谷氨酰转移酶、总胆红素、直接胆红素水平高于肝细胞癌组和健康对照组(P<0.05)。GGT和血浆Septin9甲基化组合诊断肝细胞癌较为理想,其受试者工作特征(ROC)曲线下面积(AUC)为0.845(95%CI:0.797~0.893),二分类Logistic回归模型对肝细胞癌和胆管细胞癌的鉴别诊断准确率为78.3%。结论Septin9甲基化检测能提高肝癌鉴别诊断准确率,可作为肝细胞癌早期筛查和诊断新的肿瘤标志物。Objective To explore the clinical value of Septin9 methylation in the differential diagnosis of primary carcinoma of liver(liver cancer for short).Methods The clinical data of 175 patients with primary hepatocellular carcinoma,101 patients with cholangiocarcinoma,and 163 cases with normal examinations diagnosed in the PLA General Hospital from November 2018 to November 2019 were selected as the hepatocellular carcinoma group,biliary cell carcinoma group and healthy control group,the three groups of liver function,tumor markers and plasma Septin9 methylation indicators were compared.Results The Septin9 methylation positive expression rate of 61.7%(108/175)in the hepatocellular carcinoma group was significantly higher than that of 39.6%(40/101)in the biliary cell carcinoma group and 0.0%in the healthy control group,the difference was statistically significant(P<0.05).The levels of carbohydrate antigen 199,carbohydrate antigen 125,carbohydrate antigen 153,alanine aminotransferase,aspartic aminotransferase,alkaline phosphatase,glutamine aminotransferase,total bilirubin and direct bilirubin in the biliary cell carcinoma group were significantly higher than those in the hepatocellular carcinoma group and healthy control group(P<0.05).GGT and plasma Septin9 methylation combination was ideal for the diagnosis of hepatocellular carcinoma,and the area under the receiver operating characteristics curve was 0.845(95%CI:0.797-0.893).The accuracy of differential diagnosis of hepatocellular carcinoma and biliary cell carcinoma by binary Logistic regression model was 78.3%.Conclusion Septin9 methylation test can improve the accuracy of differential diagnosis of liver cancer,and can be used as a new tumor marker for early screening and diagnosis of hepatocellular carcinoma.

关 键 词：肝癌 血浆Septin9甲基化 谷氨酰转移酶 鉴别诊断 

分 类 号：R735.7[医药卫生—肿瘤]