不同采样方法在子宫内膜癌甲基化检测辅助诊断中的效能比较  

Comparison of the effectiveness of different sampling methods in DNA methylation detection of endometrial cancer

作　　者：李莉[1] 谢涵 胡婷 周虎 李希 陈刚[1] Li Li;Xie Han;Hu Ting(Department of Obstetrics and Gynecology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030)

机构地区：[1]华中科技大学同济医学院附属同济医院妇产科,武汉430030

出　　处：《现代妇产科进展》2023年第12期881-884,共4页Progress in Obstetrics and Gynecology

基　　金：国家重点研发计划资助项目(No:2022YFC2704301)。

摘　　要：目的:比较宫腔刷和宫颈刷两种采样方法进行DNA甲基化检测(CDO1/AJAP1/GALR1)在子宫内膜癌辅助诊断中的效能,为进一步临床应用提供参考。方法:纳入2023年7月13日至2023年10月26日在华中科技大学同济医学院附属同济医院门诊就诊、因疑似子宫内膜病变拟行子宫内膜活检的患者,活检前均先后采用宫颈刷和宫腔刷采样进行DNA甲基化检测。以子宫内膜活检病理结果为诊断金标准。结果:共纳入499例患者,其中正常对照组222例,病例组277例(子宫内膜不典型增生37例,子宫内膜癌240例)。宫腔刷采样组中,CDO1/AJAP1/GALR1三靶点模式下灵敏度[96.03%(93.03%~97.77%)]和AUC[96.81%(95.09%~98.53%)]最高。宫颈刷采样组中,不论是单靶点还是三靶点模式下,灵敏度均在59.21%~75.45%之间,明显低于宫腔刷的单靶点和三靶点模式;宫腔刷采样组的特异性更高,三靶点模式下,特异性为91.89%(87.55%~94.81%),高于宫颈刷组[76.58%(70.58%~81.67%)]。当CDO1/AJAP1/GALR1三靶点联合检测时,无论在对照组还是病例组中,宫腔刷采样组的检测性能均优于宫颈刷,差异有统计学意义(P<0.05)。结论:使用宫腔刷采样进行CDO1/AJAP1/GALR1三靶点DNA甲基化检测子宫内膜癌的诊断效能较宫颈刷采样更高,适宜临床推广应用。Objective:To compare the efficacy of DNA methylation test(CDO1/AJAP1/AJD1/GALR1)in the diagnosis of endometrial cancer,so as to provide evidence for further clinical application.Methods:Patients treated in the outpatient department of Tongji Hospital from July 13,2023 to October 26,2023 who were proposed to undergo endometrial biopsy were tested by cervical brush and uterine brush sampling before biopsy.The pathological findings of the endometrial biopsy were used as the gold standard for diagnosis.Results:The study included 499 patients,222 patients in the control group and 277 in the case group(37 patients with endometrial dysplasia and 240 patients with endometrial cancer).The highest sensitivity in CDO1/AJAP1/GALR1 three-gene testing(96.03%,95%CI:93.03%~97.77%)and AUC(96.81%,95%CI:95.09%~98.53%).The sensitivity of cervical brush was between 59.21%and 75.45%in both single-gene testing and three-gene testing,which was lower than the single-gene testing and three-gene testing by uterine brush sampling.Moreover,the specificity of the uterine brush was also higher.In the three-gene testing mode,the specificity of the uterine brush was 91.89%(95%CI:87.55%~94.81%)and higher than the cervical brush(76.58%,95%CI:70.58%~81.67%).When the CDO1/AJAP1/GALR1 targets were tested,the uterine brush was better than the cervical brush in both the control and case groups,with significant statistical difference(P<0.05).Conclusion:CDO1/AJAP1/GALR1 DNA methylation testing by uterine brush sampling is more effective for endometrial cancer than cervical brush,which is suitable for clinical application.

关 键 词：子宫内膜癌 DNA甲基化 诊断 子宫内膜活检 

分 类 号：R737.33[医药卫生—肿瘤]