粪便SDC2基因甲基化检测联合FOB、CEA和CA199检测在结直肠癌早期筛查中的应用  

Application of Fecal SDC2 Gene Methylation Detection Combined with FOB,CEA and CA199 Detection in Early Screening of Colorectal Cancer

作　　者：陈小朝[1] 卢本银 付浩宇 丁楷 杨向东[1] CHEN Xiao-chao;LU Ben-yin;FU Hao-yu;DING Kai;YANG Xiang-dong(Chengdu Anorectal Specialized Hospital,Chengdu,Sichuan 611017;Chengdu Shuangliu District First People's Hospital,Chengdu,Sichuan 610202;Yilong People's Hospital,Nanchong,Sichuan 637699;Chengdu University of Traditional Chinese Medicine,Chengdu,Sichuan 610075)

机构地区：[1]成都肛肠专科医院,四川成都611017 [2]成都市双流区第一人民医院,四川成都610202 [3]仪陇县人民医院,四川南充637699 [4]成都中医药大学,四川成都610075

出　　处：《中国肛肠病杂志》2024年第3期1-5,共5页Chinese Journal of Coloproctology

基　　金：成都市科技局重点研发支撑计划项目(2022-YF05-01249-SN)。

摘　　要：目的:探讨粪便黏结蛋白聚糖2(SDC2)基因甲基化检测联合粪便潜血(FOB)、癌胚抗原(CEA)和糖类抗原199(CA199)检测在结直肠癌早期筛查中的应用价值。方法:从本院采集的358例受试者粪便样本中,实施粪便SDC2基因甲基化检测,并对结果进行深入分析。进一步筛选出符合入组条件的160例患者,分为健康对照组、疾病对照组、癌前病变组和结直肠癌组,每组各40例。补充完善血清CEA、CA199及FOB检测,统计并评估各项指标的诊断效能。结果:与健康对照组及疾病对照组对比,结直肠癌组及癌前病变组的粪便SDC2基因甲基化水平、FOB阳性率以及CEA、CA199的表达量均呈现显著性上升(P<0.05)。其中,结直肠癌组粪便SDC2基因甲基化检测的阳性率最高,为85.0%;其次为粪便潜血试验(72.5%)。这两项指标明显高于CEA和CA199的检测阳性率。针对不同特征人群进行粪便SDC2基因筛查时发现,阳性率与受检者的年龄、症状表现及其地域来源存在关联性,但与性别并无显著相关性。结论:粪便SDC2基因甲基化检测是一种简便快捷、无创且灵敏度较高的新型检测方式,能很大程度上提高早期结直肠癌及癌前病变的确诊率,与常规筛查联合应用能展现出较好的诊断价值。在结直肠癌的早期筛查方面具有广泛的应用前景和重要价值。Objective To explore the application value of fecal SDC2 gene methylation detection combined with fecal occult blood(FOB),carcinoembryonic antigen(CEA)and carbohydrate antigen 199(CA199)detection in early screening of colorectal cancer.Methods Fecal SDC2 gene methylation detection was used in 358 fecal samples collected in our hospital,and the results were analyzed in depth.Total 160 patients meeting the enrollment conditions were further selected and divided into the healthy control group,the disease control group,the precancerous group and colorectal cancer group,with 40 cases in each group.Serum levels of CEA,CA199 and FOB test were examined in all patients,and the diagnostic efficacy of each index was evaluated statistically.Results Compared with the healthy control group and disease control group,the fecal SDC2 gene methylation level,positive rate of FOB and the expression levels of CEA and CA199 in the colorectal cancer group and precancerous group were significantly increased(P<0.05).Among them,the positive rate of fecal SDC2 gene methylation detection in the colorectal cancer group was the highest(85.0%),followed by the FOB test(72.5%).The two indicators were significantly higher than the positive rates of CEA and CA199.When the fecal SDC2 gene screening was carried out for people with different characteristics,the positive rate was associated with the age,symptoms and geographical origin of the subjects,but not with gender.Conclusion The fecal SDC2 gene methylation is a new type of detection method that is simple,fast,noninvasive and highly sensitive.It can greatly improve the diagnosis rate of early colorectal cancer and precancerous lesions,and can show better diagnostic value when combined with the conventional screening.It has a wide application prospect and important value in the early screening of colorectal cancer.

关 键 词：结直肠癌 早癌筛查 SDC2基因 CEA CA199 

分 类 号：R735.34[医药卫生—肿瘤]