Septin9、HIST1H4F甲基化联合CEA、CA199在结直肠癌早期诊断中的应用  

Application of Septin9 and HIST1H4F Methylation Combined with CEA and CA199 in the Early Diagnosis of Colorectal Cancer

作　　者：文彩虹[1] 冯晓庆[2] Wen Caihong;Feng Xiaoqing(Department of Oncology,Yichang Central People's Hospital,The First College of Clinical Medical Science,China Three Gorges University,Yichang 443003,China;Department of Stomatology,Yichang Central People's Hospital,The First College of Clinical Medical Science,China Three Gorges University,Yichang 443003,China)

机构地区：[1]三峡大学第一临床医学院[宜昌市中心人民医院]肿瘤科,湖北宜昌443003 [2]三峡大学第一临床医学院[宜昌市中心人民医院]口腔科,湖北宜昌443003

出　　处：《巴楚医学》2025年第1期90-95,共6页Bachu Medical Journal

基　　金：宜昌市医疗卫生研究项目(A22-2-005)。

摘　　要：目的:探讨Septin9、HIST1H4F基因甲基化联合癌胚抗原(CEA)、糖类抗原19-9(CA199)在结直肠癌早期诊断中的应用价值。方法:选取2021年6月—2022年12月在宜昌市中心人民医院就诊的58例患者为肠癌组,50例肠道良性疾病患者为对照组。采用荧光定量聚合酶链式反应检测血浆Septin9和HIST1H4F基因甲基化水平,同时采用化学发光法检测血清肿瘤标志物CEA和CA199,采用受试者工作特征(ROC)曲线分析相关指标联合检测在结直肠癌诊断中的应用价值。结果:与对照组相比,肠癌组患者血浆中Septin9(60.34%vs 8.00%)和HIST1H4F(48.28%vs 4.00%)基因甲基化阳性率、CEA(46.55%vs 10.00%)和CA199(36.21%vs 6.00%)的阳性率明显升高(均P<0.001)。Septin9和HIST1H4F双基因甲基化联合检测结直肠癌的灵敏度为79.31%,特异度为90.0%,曲线下面积(AUC)为0.847;血清CEA和CA199联合检测结直肠癌的灵敏度为60.34%,特异度为88.00%,AUC为0.742;四项指标联合检测结直肠癌的灵敏度为87.93%,特异度为82.00%,AUC为0.850。四种标志物均对中晚期(Ⅲ期和Ⅳ期)结直肠癌更敏感,相对于CEA联合CA199,Septin9联合HIST1H4F甲基化对于Ⅰ/Ⅱ期结直肠癌的检出率更高。结论:Septin9、HIST1H4F基因甲基化和CEA、CA199水平联合检测可提高对结直肠癌患者诊断的灵敏度,有望成为结直肠癌患者早期辅助诊断的指标。Objective:To explore the application value of Septin9,HIST1H4F methylation combined with carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA199)in the early diagnosis of colorectal cancer.Methods:We selected 58 patients with colorectal cancer treated in Yichang Central Hospital from June 2021 to December 2022 as the bowel cancer group and 50 patients with intestinal benign diseases as the control group.Fluorescence quantitative polymerase chain reaction was used to detect the methylation levels of Septin9 and HIST1H4F genes in plasma,and chemiluminescence was used to detect serum tumor markers CEA and CA199.The receiver operating characteristic(ROC)curve was used to analyze the application value of combined detection of related indicators in the diagnosis of colorectal cancer.Results:Compared with the control group,the positive rates of Septin9(60.34%vs 8.00%)and HIST1H4F(48.28%vs 4.00%)methylation,CEA(46.55%vs 10.00%),and CA199(36.21%vs 6.00%)in the plasma of patients in the colorectal cancer group were significantly higher(all P<0.001).The sensitivity of combined detection of colorectal cancer by Septin9 and HIST1H4F dual gene methylation was 79.31%,the specificity was 90.0%,and the area under the curve(AUC)was 0.847.The sensitivity of combined detection of colorectal cancer by serum CEA and CA199 was 60.34%,the specificity was 88.00%,and the AUC was 0.742.The sensitivity of combined detection of the four indicators for colorectal cancer was 87.93%,the specificity was 82.00%,and the AUC was 0.850.All four markers were more sensitive to advanced(stageⅢandⅣ)colorectal cancer.Compared to CEA combined with CA199,Septin9 combined with HIST1H4F methylation had a higher detection rate for stageⅠ/Ⅱcolorectal cancer.Conclusion:Combined detection of Septin9,HIST1H4F methylation,CEA and CA199 can improve the diagnostic sensitivity for patients with colorectal cancer and is expected to become an indicator for early auxiliary diagnosis of colorectal cancer.

关 键 词：结直肠癌 甲基化 Septin9 HIST1H4F 

分 类 号：R735.37[医药卫生—肿瘤]