SDC2基因甲基化检测在结直肠癌筛查中的价值研究  

Detection of SDC2 gene methylation in fecal samples for early diagnosis of colorectal cancer

作　　者：林日旭 郭瑛 谢春明 黄卡特[1] 李剑敏[1] 陈国荣[1] LIN Rixu;GUO Ying;XIE Chunming;HUANG Kate;LI Jianmin;CHEN Guorong(Department of Pathology,the First Affiliated Hospital of Wenzhou Medical University,Wenzhou 325000,China;不详)

机构地区：[1]温州医科大学附属第一医院病理科,325000 [2]温州医科大学第一临床医学院 [3]平阳人民医院内镜中心

出　　处：《浙江医学》2022年第23期2531-2534,2538,共5页Zhejiang Medical Journal

摘　　要：目的探究粪便重组人黏结蛋白聚糖2(SDC2)基因甲基化检测在结直肠癌(CRC)早期筛查中的价值。方法收集2019年7-10月在温州医科大学附属第一医院就诊的88例CRC患者、47例结直肠进展期腺瘤患者、238例对照人群(肠癌术后、其他癌症、其他肠道疾病及肠道健康人群)粪便,使用SDC2基因甲基化检测试剂盒检测粪便中SDC2甲基化情况,分析其对CRC及结直肠进展期腺瘤诊断的特异度、灵敏度、假阳性率、假阴性率、阳性预测值、阴性预测值;绘制ROC曲线,评估其在CRC和进展期腺瘤诊断中的精确度和区分度。结果粪便SDC2基因甲基化检测对于CRC及结直肠进展期腺瘤患者诊断的灵敏度分别为0.841和0.553,总体灵敏度为0.741,假阴性率为0.259;阴性对照样本筛查中,粪便SDC2基因甲基化检测CRC的特异度为0.882,假阳性率为0.118;粪便SDC2基因甲基化检测CRC及结直肠进展期腺瘤的阳性预测值、阴性预测值分别为0.781和0.857,总符合率为0.831,AUC为0.819,Kappa=0.63,P<0.05,说明两者具有较高的一致性。结论粪便SDC2基因甲基化检测对CRC筛查具有高的灵敏度和特异度,可为CRC无创筛查和早期诊断提供依据。Objective To explore the value of syndecan-2(SDC2)gene methylation detection in fecal samples for early diagnosis of colorectal cancer(CRC).Methods Fecal samples were collected from 88 patients with colorectal cancer,47 patients with advanced colorectal adenoma and 238 controls(patients with postoperative bowel cancer,patients with other types of cancer,patients with other intestinal diseases,and healthy subjects)in the First Affiliated Hospital of Wenzhou Medical University from July to October 2019.The SDC2 gene methylation was determined with SDC2 gene methylation detection kits.The value of methylated SDC2 gene for detection of CRC and advanced adenoma was analyzed.The ROC curve was use to assess the accuracy and discrimination of SDC2 methylation in detection of CRC and advanced adenoma.Results The sensitivity of fecal SDC2 gene methylation for CRC and advanced colorectal adenomawas 0.841 and 0.553,respectively;and the overall sensitivity of both was 0.741.The specificity of fecal SDC2 gene methylation for CRC was 0.882.The positive predictive value and negative predictive value of SDC2 gene methylation for CRC and advanced colorectal adenoma were0.781 and 0.857,respectively.The total coincidence rate between colonoscopy and fecal SDC2 gene methylation was 0.831.The area under ROC curve(AUC)of fecal SDC2 gene methylation in predicting CRC and advanced colorectal adenoma was0.819,and Kappa=0.63.Conclusion The fecal SDC2 gene methylation detection has relatively high sensitivity and specificity for colorectal cancer,which may be used for screening and early diagnosis of CRC.

关 键 词：粪便重组人黏结蛋白聚糖2基因甲基化 肠镜 结直肠癌 筛查 

分 类 号：R735.34[医药卫生—肿瘤]