粪便SDC2基因甲基化检测对贵州地区结直肠癌的早筛价值  

Early screening value of stool SDC2 gene methylation test for colorectal cancer in Guizhou

作　　者：晏芳 吴世敏 杨赟翰 袁文强 崔德军[1] Yan Fang;Wu Shimin;YangYunhan;YuanWenqiang;Cui Dejun(Department of Gastroenterology,Guizhou Provincial People’s Hospital,Guiyang 550002,Guizhou,China;Graduate School,Zunyi Medical University,Guiyang 550002,Guizhou,China)

机构地区：[1]贵州省人民医院消化内科,贵州贵阳550002 [2]遵义医科大学研究生院,贵州遵义563000

出　　处：《贵州医药》2025年第2期181-184,188,共5页Guizhou Medical Journal

基　　金：贵州省人民医院国家自然科学基金培育基金(黔科合平台人才[2018]5764-11);贵州省卫生健康委科学技术基金(gzwkj2025-268)。

摘　　要：目的观察贵州地区粪便黏结蛋白聚糖2(SDC2)基因甲基化检测在结直肠癌及癌前病变诊断的临床价值。方法选取2023年4月至2024年7月期间在贵州省人民医院消化内科门诊及住院就诊的患者1980例进行研究,收集所有患者的粪便样本进行粪便SDC2基因甲基化检测(mSDC2),对检查结果为阳性者建议接受肠镜检查,对肠镜异常者建议接受进一步治疗。观察mSDC2初筛的阳性预测值(PPV)、肠镜依从率、肠道病变检出率;同时探讨mSDC2的CT值与肠道病变之间的关系。结果mSDC2阳性共1980例患者,年龄19~99岁,检测结果中207例患者mSDC2结果为阳性,PPV为10.45%(207/1980),PPV在男性和女性中无统计学意义(P>0.05)。207例mSDC2阳性受试者中109例接受结直肠镜检查(肠镜依从性52.66%),其中男62例(肠镜依从性52.54%);女47例(肠镜依从性52.81%,其中产妇1例),比较男性和女性的肠镜依从性无显著差异(P>0.05)。通过肠镜检查发现肠道病变共77例,mSDC2对肠癌的PPV为16.51%;对肠道病变的PPV为70.64%,各年龄段行肠镜检查的比例存在显著差异(P<0.05)。mSDC2CT值≤38为阳性结果。CT值在肠道肿瘤与肠道其他病变的mSDC2存在显著差异(P<0.05)。结论粪便SDC2基因甲基化检测作为一种新颖的、非侵入性的结直肠癌早诊早筛技术,具有较高的临床诊断价值,为贵州地区患者的肠癌风险分层与结直肠癌早诊早筛提供了有效工具。Objective To observe the clinical value of stool SDC2 gene methylation test in the diagnosis of colorectal cancer and precancerous lesions in Guizhou.Methods A comprehensive analysis was conducted on a sample population of 1980 patients who were admitted to the of Department of Gastroenterology in Guizhou Provincial People’s Hospital between April 2023 and July 2024 for the purpose of this investigation.Stool specimens were prospectively collected from each individual for the determination of stool SDC2 gene methylation status(terms mSDC2).Subsequent to the molecular analysis,patients demonstrating positive results were advised to the colonoscopic examinations,with a recommendation for follow-up therapeutic interventions in case of colonoscopic abnormalities.The positive predictive value(PPV),compliance rate with colonoscopy,and intestinal lesion detection rate of the initial screening of mSDC2 were meticulously monitored.Furthermore,an exploration of the correlation between the CT value of mSDC2 and the presence of intestinal lesions was conducted.Rersults A comprehensive analysis of the data revealed that out of a total of 1980 patients,ranging in age from19 to 99 years,207 subjects tested positive for mSDC2.with a PPV of 10.45%(207/1980),a figure that there were no demonstrate statistically significant differences between genders(P>0.05).109 of the 207 subjects positive for mSDC2 underwent colonoscopy that indicating a compliance rate was 52.66%,within this group,62 were male that colonoscopy compliance rate of 52.54%,and 47 were female that colonoscopy compliance rate of 52.81%,one of whom was a woman in labor,and there were no statistically significant differences in colonoscopy compliance between genders(P>0.05).Notably,a total of 77 cases of intestinal lesions were detected by colonoscopy.mSDC2 PPV for intestinal cancer was 16.51%.Whereas the PPV for detecting intestinal lesions was 70.64%,and the rate of colonoscopy examination varied significantly across different age groups(P<0.05).A CT value of≤38

关 键 词：粪便 SDC2基因甲基化检测 贵州 结直肠癌 早筛 

分 类 号：R735.3[医药卫生—肿瘤]