外周血DLGAP5和RASSF1A基因甲基化对肺结节良恶性诊断价值研究  

Value of Peripheral Blood DLGAP5 and RASSF1A Gene Methylation in the Differential Diagnosis of Benign and Malignant Lung Nodules

作　　者：周红梅[1] 赵晓彬 吴亚光 肖敬 ZHOU Hongmei;ZHAO Xiaobin;WU Yaguang;XIAO Jing(Department of Pulmonology,Hebei Seventh People’s Hospital,Hebei Dingzhou 073000,China;Department of Oncology,Hebei Seventh People’s Hospital,Hebei Dingzhou 073000,China)

机构地区：[1]河北省第七人民医院肺病科,河北定州073000 [2]河北省第七人民医院肿瘤科,河北定州073000

出　　处：《现代检验医学杂志》2025年第2期53-58,共6页Journal of Modern Laboratory Medicine

摘　　要：目的探究外周血Discs大同源物相关蛋白5(DLGAP5)和Ras相关区域家族蛋白1A(RASSF1A)甲基化水平对肺结节良恶性鉴别诊断的价值。方法选取2022年12月~2024年6月河北省第七人民医院收治的110例肺结节患者作为研究对象。根据病理检查确诊,将52例恶性肺结节患者纳入恶性组,58例良性肺结节患者纳入良性组。通过实时定量聚合酶链反应(qRT-PCR)法测定外周血DLGAP5和RASSF1A基因甲基化水平;分析外周血DLGAP5和RASSF1A基因甲基化对肺结节良恶性的诊断价值及其与恶性肺结节患者临床病理特征的关系;采用Spearman法分析DLGAP5和RASSF1A基因甲基化水平与临床病理特征的相关性。结果与良性组相比,恶性组患者外周血DLGAP5和RASSF1A基因甲基化水平均较高,差异具有统计学意义(χ^(2)=27.010,24.350,均P<0.001);DLGAP5甲基化和RASSF1A甲基化单独检测恶性肺结节的敏感度分别为61.54%,67.31%,特异度分别为86.21%,79.31%,准确度分别为74.55%,73.63%。且两基因甲基化联合检测对恶性肺结节的敏感度(84.62%)和准确度(83.64%)均优于单个基因甲基化(Z=2.816,2.497,均P<0.05)。DLGAP5甲基化和RASSF1A甲基化单独检测及联合检测与病理结果的一致性Kappa值分别为0.583,0.569和0.712。恶性肺结节患者结节大小、组织学分化程度、淋巴结转移及毛刺征与DLGAP5和RASSF1A甲基化水平相关,差异具有统计学意义(χ^(2) DLGAP5=4.644~14.981,χ^(2) RASSF1A=4.293~12.629,均P<0.05)。相关性分析显示,DLGAP5和RASSF1A基因甲基化水平与结节大小、组织学分化、淋巴结转移和毛刺征呈正相关(rDLGAP5=0.512~0.683,rRASSF1A=0.527~0.691,均P<0.05)。结论外周血中DLGAP5和RASSF1A基因甲基化与组织学分化、淋巴结转移、临床分期密切相关,二者联合检测对肺结节良恶性具有较高的鉴别诊断价值。Objective To investigate the value of methylation levels of Discs large-associated protein5(DLGAP5)and Ras association domain family 1A(RASSF1A)in peripheral blood in the differential diagnosis of benign and malignant lung nodules.Methods 110 patients with pulmonary nodules admitted to the Seventh People’s Hospital of Hebei Province from December 2022 to June 2024 were selected as study subjects.Based on the diagnosis confirmed by pathological examination,52 patients with malignant lung nodules were included in the malignant group and 58 patients with benign lung nodules were included in the benign group.The methylation levels of DLGAP5 and RASSF1A genes in peripheral blood were determined by quantitative realtime polymerase chain reaction(qRT-PCR).The diagnostic value of methylation of DLGAP5 and RASSF1A genes in peripheral blood on the benign and malignant nature of lung nodules and their relationship with clinicopathological characteristics of patients with malignant lung nodules were analyzed.Spearman’s method was used to analyze the correlation between DLGAP5 and RASSF1A gene methylation levels and clinicopathological features.Results Compared with the benign group,the methylation levels of DLGAP5 and RASSF1A genes were higher in the peripheral blood of patients in the malignant group,and the differences were statistically significant(χ^(2)=27.010,24.350,all P<0.001).The sensitivities of DLGAP5 methylation and RASSF1A methylation alone in the detection of malignant lung nodules were 61.54%,67.31%,and the specificity were 86.21%,79.31%,and the accuracies were 74.55%,73.63%,respectively.The sensitivity(84.62%)and accuracy(83.64%)of the combined two-gene methylation test for malignant lung nodules were better than that of single gene methylation(Z=2.816,2.497,all P<0.05).The concordance Kappa values of DLGAP5 methylation and RASSF1A methylation alone and in combination with the pathological results were 0.583,0.569 and 0.712,respectively.The nodules size,histological differentiation degree,lymph nodes and

关 键 词：肺结节 良恶性鉴别 Discs大同源物相关蛋白5 Ras相关区域家族蛋白1A 

分 类 号：R734.2[医药卫生—肿瘤] R730.43[医药卫生—临床医学]