血浆游离DNA中RERG和ZNF671甲基化在鼻咽癌检测中的临床意义  

Clinical significance of RERG and ZNF671 promoter methylation status in plasma cell-free DNA in nasopharyngeal carcinoma

作　　者：王正和 冯勇军[2] 吴李仲 吴祥基 Zhenghe Wang;YongJun Feng;Lizhong Wu;Xiangji Wu(Department of Otolaryngology,Qionghai People’s Hospital,Qionghai 571400,China;Department of Otolaryngology,The Second Affiliated Hospital of Hainan Medical University,Haikou 570311,China)

机构地区：[1]琼海市人民医院耳鼻喉科,海南省琼海市571400 [2]海南医学院第二附属医院耳鼻喉科

出　　处：《中国肿瘤临床》2022年第17期880-885,共6页Chinese Journal of Clinical Oncology

基　　金：海南省自然科学基金项目(编号:817313)资助。

摘　　要：目的:探究血浆游离DNA(cell-free DNA,cfDNA)中RAS样雌激素调节生长抑制剂(RAS-like estrogen-regulated growthinhibitor,RERG)、锌脂蛋白671(zinc finger protein 671,ZNF671)甲基化在鼻咽癌(nasopharyngeal carcinoma,NPC)检测中的临床意义。方法:选取2020年2月至2021年3月琼海市人民医院确诊且未治疗的NPC患者106例作为NPC组、同期150例健康志愿者作为正常对照组、100例确诊为鼻咽部慢性黏膜炎的患者作为良性对照组;分析组织和血浆cfDNA中RERG、ZNF671启动子甲基化状态,采用受试者工作特征(receiver operating characteristic,ROC)曲线分析血浆cfDNA RERG、ZNF671启动子甲基化状态对NPC早期诊断的价值。结果:NPC组血浆cfDNA RERG、ZNF671启动子甲基化率及甲基化程度显著高于良性及正常对照组(P<0.05)。经Kappa一致性检验,NPC组患者组织与血浆cfDNA中RERG(45.28%vs. 38.68%,Kappa值为0.788,P<0.001)、ZNF671(55.66%vs. 48.11%,Kappa值为0.791,P<0.001)启动子甲基化率检验结果的Kappa值为0.6~0.85,认为一致性较好。经ROC曲线分析,血浆cfDNA RERG和ZNF671启动子甲基化程度联合诊断NPC的灵敏度和特异性分别为98.1%、特异度88.8%,曲线下面积为0.981,甚至优于肿瘤标志物癌胚抗原的单独诊断。结论:联合检测血浆cfDNA中RERG、ZNF671启动子甲基化状态对NPC患者诊断有良好的临床价值。Objective:To investigate the clinical significance of the methylation status of RAS-like,estrogen-regulated growth-inhibitor(RERG)and zinc finger protein 671(ZNF671)in plasma cell-free DNA(cfDNA)in nasopharyngeal carcinoma(NPC).Methods:A total of 106 patients with diagnosed and untreated NPC in Qionghai People’s Hospital from February 2020 to March 2021 were selected as the NPC group.During the same period,150 healthy volunteers were selected as the normal control group,and 100 patients diagnosed with chronic mucositis of the nasopharynx were selected as the benign control group.The RERG and ZNF671 promoter methylation status in plasma cfDNA and tissues was determined.The receiver operating characteristic(ROC)curve was used to analyze the value of the plasma cfDNA RERG and ZNF671 methylation status for the early diagnosis of NPC.Results:Plasma cfDNA RERG and ZNF671 promoter methylation rates and the degree of methylation were significantly higher in the NPC group than those in the benign and normal control groups(P<0.05).After the Kappa consistency test,the Kappa values of the tissue and plasma cfDNA RERG(45.28%vs.38.68%,Kappa=0.788,P<0.001)and ZNF671(55.66%vs.48.11%,Kappa=0.791,P<0.001)promoter methylation rates were between 0.6 and 0.85,which were considered to be in good agreement.ROC curve analysis showed that the sensitivity,specificity,and area under the curve of the combined diagnosis based on the plasma cfDNA RERG and ZNF671 promoter methylation rate for NPC were 98.1%,88.8%,and 0.981,respectively,which were better than those from the single diagnosis-based carcinoembryonic antigen.Conclusions:Combined evaluation of plasma cfDNA RERG and Zn F671 promoter methylation status may help in early diagnosis of NPC.

关 键 词：鼻咽癌 血浆游离DNA RAS样雌激素调节生长抑制剂 锌脂蛋白671 临床病理特征 

分 类 号：R739.63[医药卫生—肿瘤]