粪便脱落细胞BMP3与BCAT1基因甲基化检测对结肠癌及癌前病变筛查的价值  

The value of detection of BMP3 and BCAT1 gene methylation in fecal exfoliated cells in the screening of colon cancer and precancerous lesions

作　　者：李红海 张晓钿 房一鸣 吴俊梅 Li Honghai;Zhang Xiaodian;Fang Yiming;Wu Junmei(Department of Gastrointestinal Oncology, The First Affiliated Hospital of Hainan Medical College, Hainan Province, Haikou 570000, China)

机构地区：[1]海南医学院第一附属医院胃肠肿瘤外科,海口570000 [2]海南医学院海南省药物安全性评价研究中心

出　　处：《疑难病杂志》2021年第7期699-703,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：海南省自然科学基金青年基金项目(818QN245)。

摘　　要：目的分析粪便脱落细胞骨形态发生蛋白3(BMP3)、支链氨基酸氨基转移酶1(BCAT1)甲基化对结肠癌及癌前病变筛查的价值。方法纳入2020年2—12月海南医学院第一附属医院胃肠肿瘤外科患者94例,其中结肠癌患者43例(结肠癌组)、结肠腺瘤患者19例(结肠腺瘤组)、单纯痔疮患者32例(对照组),收集结肠癌患者的临床分期、肿瘤最大径、肿瘤体积、分化程度、淋巴结转移、浸润程度情况;取其粪便样本采用甲基化特异性PCR(MSP)检测粪便脱落细胞BMP3、BCAT1甲基化情况;分析结肠癌患者粪便脱落细胞BMP3、BCAT1及二者联合基因甲基化与临床病理特征关系;受试者工作特征曲线(ROC)评价BMP3、BCAT1单基因及二者联合基因甲基化对结肠腺瘤和结肠癌的诊断价值。结果粪便脱落细胞BMP3、BCAT1单基因及二者联合基因甲基化阳性率比较,结肠癌组>结肠腺瘤组>对照组(χ^(2)/P=18.462/0.000、24.203/0.000、56.039/0.000)。粪便脱落细胞BMP3与BCAT1联合基因甲基化结肠癌患者肿瘤最大径、肿瘤体积大于非甲基化患者(t/P=11.417/0.000、3.381/0.002),分化程度越低、临床分期越高基因甲基化阳性率越高,且高于非甲基化患者(χ^(2)/P=11.646/0.003、4.882/0.027)。粪便脱落细胞BMP3、BCAT1单基因及二者联合基因甲基化对结肠腺瘤诊断的ROC曲线显示,BMP3基因甲基化(AUC=0.579,95%CI 0.433~0.716)、BCAT1基因甲基化(AUC=0.521,95%CI 0.377~0.663)、二者联合基因甲基化(AUC=0.574,95%CI 0.428~0.711),三者AUC比较,差异无统计学意义(Z=0.052,P=0.959)。以上指标对结肠癌诊断的ROC曲线显示,BMP3基因甲基化(AUC=0.701,95%CI 0.585~0.802)、BCAT1基因甲基化(AUC=0.744,95%CI 0.630~0.838)、二者联合基因甲基化(AUC=0.852,95%CI 0.752~0.924),三者AUC比较,BMP3与BCAT1联合基因甲基化的AUC最高(Z=3.598,P=0.000)。结论粪便脱落细胞BMP3、BCAT1甲基化对结肠癌癌前病变筛选价值不大,但对结肠癌有较高的筛�Objective To analyze the value of fecal exfoliated cells bone morphogenetic protein 3(BMP3)and branched chain amino acid aminotransferase 1(BCAT1)methylation in the screening of colon cancer and precancerous lesions.Methods From February to December 2020,94 patients with gastrointestinal tumor surgery in the First Affiliated Hospital of Hainan Medical College were included,including 43 patients with colon cancer(colon cancer group),19 patients with colon adenoma(colon adenoma group),and patients with simple hemorrhoids In 32 cases(control group),the clinical stage,maximum tumor diameter,tumor volume,degree of differentiation,lymph node metastasis,and degree of invasion of colon cancer patients were collected.Stool samples used methylation-specific PCR(MSP)to detect the methylation of BMP3 and BCAT1 in fecal exfoliated cells.Analyze the relationship between BMP3,BCAT1 and the combination of gene methylation and clinicopathological characteristics of fecal exfoliated cells in patients with colon cancer.Receiver operating characteristic curve(ROC)evaluates the diagnostic value of BMP3,BCAT1 single gene and their combined gene methylation for colon adenoma and colon cancer.Results Comparison of the positive rates of BMP3,BCAT1 single gene and their combined gene methylation in fecal exfoliated cells,colon cancer group>colon adenoma group>control group(χ^(2)/P=18.462/0.000,24.203/0.000,56.039/0.000).Fecal exfoliated cells BMP3 and BCAT1 combined gene methylation of colon cancer patients with maximum diameter and tumor volume are larger than those of non-methylated patients(t/P=11.417/0.000,3.381/0.002).The lower the degree of differentiation and the higher the clinical stage,the higher the positive rate of gene methylation,and it is higher than that of non-methylated patients(χ^(2)/P=11.646/0.003,4.882/0.027).The ROC curve of fecal exfoliated cells BMP3,BCAT1 single gene and their combined gene methylation for the diagnosis of colon adenoma showed that BMP3 gene methylation(AUC=0.579,95%CI 0.433-0.716),BCAT1 gene me

关 键 词：骨形态发生蛋白3 支链氨基酸氨基转移酶1 甲基化 结肠癌 癌前病变 

分 类 号：R735.35[医药卫生—肿瘤]