结直肠癌患者血浆Septin9 DNA甲基化联合FOBT检测的临床应用价值  

Clinical application value of plasma Septin9 DNA methylation combined with FOBT detection in patients with colorectal cancer

作　　者：李娜[1] 惠凌云[1] 冯艾[1] 张琳[1] 王亚文[1,2] LI Na;HUI Lingyun;FENG Ai;ZHANG Lin;WANG Yawen(Department of Clinical Laboratory,the First Affiliated Hospital of Xi’an Jiaotong University,Shaanxi Xi'an 710061,China;Biobank,the First Affiliated Hospital of Xi'an Jiaotong University,Shaanxi Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院检验科,陕西西安710061 [2]西安交通大学第一附属医院生物样本库,陕西西安710061

出　　处：《现代肿瘤医学》2023年第6期1085-1090,共6页Journal of Modern Oncology

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

摘　　要：目的:探讨血浆Septin9 DNA甲基化及粪便隐血试验(FOBT)在结直肠癌(CRC)诊断中的应用价值。方法:回顾性收集2017年6月至2022年1月我院收治并经病理检查确诊的101例结直肠良性腺瘤患者、209例结直肠癌患者分别作为良性腺瘤组和结直肠癌组,选取同期在我院进行体检的98例健康人群作为正常对照组,比较三组一般资料及血浆Septin9 DNA甲基化及FOBT阳性情况,比较不同病理特征、不同临床分期结直肠癌患者血浆Septin9 DNA甲基化、FOBT阳性情况,采用受试者工作曲线(ROC)评估血浆Septin9 DNA甲基化、FOBT单项及联合检测对结直肠癌的诊断价值。结果:三组血浆Septin9 DNA甲基化、FOBT阳性率比较,结直肠癌组高于良性腺瘤组及正常对照组,良性腺瘤组高于正常对照组(P<0.05);肿瘤低分化、淋巴结转移、脉管/神经侵犯的结直肠癌患者血浆Septin9 DNA甲基化和FOBT阳性率高于肿瘤高分化、中分化及未发生淋巴结转移、未发生脉管/神经侵犯的结直肠癌患者(P<0.05);随着结直肠癌TNM临床分期升高,血浆Septin9 DNA甲基化及FOBT阳性率升高,差异具有统计学意义(P<0.05);血浆Septin9 DNA甲基化和FOBT联合诊断结直肠癌的敏感度、曲线下面积(AUC)(87.08%、0.885)均高于两者单独诊断(59.33%、0.744和52.63%、0.643,P<0.05);血浆Septin9 DNA甲基化诊断结直肠癌的特异度、阳性预测值和阴性预测值分别为89.45%、85.52%和67.68%;FOBT分别为76.38%、70.06%和60.56%,两者联合诊断分别为89.95%、90.10%和86.89%。联合诊断优于单项诊断。结论:随着结直肠病变恶性程度的增加,血浆Septin9 DNA甲基化和FOBT阳性率升高,血浆Septin9 DNA甲基化、FOBT联合检测对结直肠癌具有较高的诊断价值,可作为结直肠癌的实验室诊断指标。Objective:To investigate the application value of plasma Septin9 DNA methylation and fecal occult blood test(FOBT) in the diagnosis of colorectal cancer.Methods:The clinical data of 101 patients with colorectal benign adenoma and 209 patients with colorectal cancer who were diagnosed by pathological examination in our hospital from June 2017 to January 2022 were retrospectively collected as the benign adenoma group and the colorectal cancer group, respectively.The physical examination data of 98 healthy people who underwent physical examination in our hospital in the same period were selected as the normal control group, and the general data, plasma Septin9 DNA methylation and FOBT positive status of the three groups were compared.The plasma Septin9 DNA methylation and FOBT positive status of colorectal cancer patients with different pathological features and clinical stages were compared.The receiver operating curve(ROC) was used to assess the diagnostic value of plasma Septin9 DNA methylation and FOBT tests alone and in combination for colorectal cancer.Results:Compared with the three groups, the positive rates of plasma Septin9 DNA methylation and FOBT in the colorectal cancer group were higher than those in the benign adenoma group and the normal control group, and those in the benign adenoma group were higher than those in the normal control group(P<0.05).The positive rates of plasma Septin9 DNA methylation and FOBT in colorectal cancer patients with low tumor differentiation,lymph node metastasis and vascular/nerve invasion were higher thanthose in CRC patients with high tumor differentiation,moderate tumor differentiation,and CRC patients without lymphnode metastasis and vascular/nerve invasion(P< 0. 05). With the increase of TNM clinical stage of colorectal canc-er,the positive rate of plasma Septin9 DNA methylation and FOBT increased,and the difference between groups wasstatistically significant(P< 0. 05). The sensitivity and area under curve(AUC) of Septin9 DNA methylation com-bined with FOBT in the dia

关 键 词：结直肠癌 良性腺瘤 粪便隐血试验 Septin9 DNA甲基化 

分 类 号：R735.3[医药卫生—肿瘤]