mSEPT9和CEA在结直肠癌诊断与术后评估及复发监测中的价值  

Value of mSEPT9 and CEA in diagnosis,postoperative evaluation and recurrence monitoring of colorectal cancer

作　　者：高娟娟 黎阳[2] 王中林 冯艾[3] 李娜[3] 惠凌云[3] GAO Juanjuan;LI Yang;WANG Zhonglin;FENG Ai;LI Na;HUI Lingyun(Biobank,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shanxi,China,710061;De-partment of Clinical Laboratory,Xi'an Central Hospital,Xi􀆳an,Shanxi,China,710004;Department of Clin-ical Laboratory,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shanxi,China,710061)

机构地区：[1]西安交通大学第一附属医院生物样本信息资源中心,陕西西安710061 [2]西安市中心医院检验科,陕西西安710004 [3]西安交通大学第一附属医院检验科,陕西西安710061

出　　处：《分子诊断与治疗杂志》2022年第2期205-209,共5页Journal of Molecular Diagnostics and Therapy

基　　金：西安交通大学第一附属医院临床研究课题(XJTU1AF-CRF-2017-014)。

摘　　要：目的探讨血浆Septin9基因甲基化(mSEPT9)和癌胚抗原(CEA)检测对结直肠癌(CRC)实验室诊断、手术治疗效果评价及肿瘤复发监测的临床应用价值。方法以2017年6月至2020年1月在西安交通大学第一附属医院确诊为CRC的243例患者为病例组,其中CRC根除治疗术前的119例为术前组,根除治疗术后的99例为术后组,根除治疗术后复发的25例为术后复发组,以同期的81例健康体检人员为对照组。所有入组人员均采用荧光定量PCR法检测血浆mSEPT9,采用电化学发光法检测CEA。通过比较四个组mSEPT9与CEA检测结果的差异,评价其在CRC患者中的临床应用价值。结果在CRC术前组,随着肿瘤分期的进展mSEPT9阳性率增加,差异有统计学意义(P<0.05);与隆起型肿瘤比较,溃疡型和浸润型肿瘤mSEPT9的阳性率较高,差异有统计学意义(P<0.05)。与健康对照组比较,mSEPT9和CEA在CRC术前组的阳性率显著升高,差异有统计学意义(P<0.001)。mSEPT9在术前组的检测阳性率高于CEA,差异有统计学意义(P<0.05);mSEPT9在术后组的检测阴性率高于CEA,差异有统计学意义(P<0.05);m SEPT9在术后复发组的检测阳性率高于CEA,差异无统计学意义(P>0.05)。CRC术后复发组m SEPT9和CEA检测的AUC分别为0.955和0.857,两项联合检测的灵敏度可达100%。结论mSEPT9作为CRC诊断、手术治疗效果评估及肿瘤复发监测的分子诊断指标均优于CEA。mSEPT9与CEA二者联合检测,可提高肿瘤复发监测的灵敏度。Objective To evaluate the clinical application of plasma methylated Septin9(mSEPT9)and carcinoembryonic antigen(CEA)in diagnosis,postoperative evaluation and recurrence monitoring of colorectal cancer(CRC).Methods The 243 patients diagnosed with CRC in the First Affiliated Hospital of Xi’an Jiaotong University from June 2017 to January 2020 were selected as the case group.Of which119 patients who did not receive CRC eradication treatment were the preoperative group,99 cases who underwent eradication treatment were the postoperative group,and 25 cases who had recurrence after eradication treatment were the postoperative recurrence group.And 81 healthy physical examiners during the same period were the control group.All participants were tested for mSEPT9 and CEA.By comparing the results of mSEPT9 and CEA test among CRC cases and healthy controls,the clinical value of the two makers in CRC patients was evaluated.Results In the preoperative group of CRC,the positive rate of mSEPT9 increased significantly with the progress of tumor stage(P<0.05).And the positive rates of m SEPT9 in ulcerative and invasive tumors were higher than that of protruded-type tumors(P<0.05).Compared with the healthy control group,the positive rates of m SEPT9 and CEA in the preoperative-CRC group significantly increased(P<0.001).Moreover,the positive rate of m SEPT9 in the preoperative group was higher than that of CEA(P<0.05);the negative rate of m SEPT9 among postoperative cases was significantly higher than that of CEA(P<0.05);the positive rate of m SEPT9 in the postoperative recurrence group was higher than that of CEA,but the difference was not statistically significant(P>0.05).In addition,in the postoperative recurrence group,the AUC of m SEPT9 and CEA were 0.955 and 0.857,respectively,and the sensitivity of the two combined detection was up to 100%.Conclusion m SEPT9 is better than CEA as a molecular diagnostic indicator for CRC diagnosis,surgical treatment effect evaluation and tumor recurrence monitoring.The combined detection of

关 键 词：结直肠癌 mSEPT9 CEA 辅助诊断 复发监测 

分 类 号：R735.34[医药卫生—肿瘤]