| 粪便多基因联合检测在结直肠癌早期筛查中的应用 |
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| 引用本文： | 邵书先,沈忠,张秀峰,王东,王厚东.粪便多基因联合检测在结直肠癌早期筛查中的应用[J].中华全科医学,2020,18(11):1819-1822. |
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| 作者姓名： | 邵书先 沈忠 张秀峰 王东 王厚东 |
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| 作者单位： | 杭州市第三人民医院肛肠外科, 浙江 杭州 310009 |
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| 基金项目： | 浙江省科技厅基础公益研究计划项目(LGF20H030002)国家自然科学基金面上项目(31770979) |
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| 摘 要： | 目的 研究联合检测粪便中sFRP2、Vimentin和HPP1基因甲基化状态在结直肠癌早期筛查中的应用。 方法 将杭州市第三人民医院2017年10月—2019年10月期间收治的结直肠癌患者60例为结直肠癌组,由腺瘤性息肉患者60例及正常健康人30例组成非结直肠癌组(90例),收集清晨粪便标本,提取粪便DNA,并进行亚硫酸氢盐修饰处理,采用甲基化特异性PCR检测sFRP2、Vimentin和HPP1基因甲基化状态,分析其与结直肠癌临床病理特征的关系,比较3个基因联合检测诊断敏感度及特异度。 结果 在结直肠癌患者中,检测sFRP2、Vimentin和HPP1单基因甲基化敏感度分别为46.7%、43.3%、53.3%,特异度分别为73.3%、75.6%、76.7%;联合组以3个基因中任1个基因甲基化表达阳性判为阳性,联合检测诊断结直肠癌的敏感度为83.3%,特异度为46.7%,敏感度均高于sFRP2、Vimentin和HPP1单基因甲基化检测。3个基因甲基化状态与结直肠癌患者的性别、年龄、肿瘤部位、淋巴结转移及TNM分期均无关(均P>0.05)。 结论 在结直肠癌患者粪便DNA中sFRP2、Vimentin和HPP1基因异常甲基化发生率明显高于非结直肠癌患者,联合检测粪便多基因筛查结直肠癌优于单基因检测,在结直肠癌早期筛查应用中具有重要意义。
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| 关 键 词： | 粪便 多基因 结直肠癌 筛查 |
| 收稿时间： | 2020-06-08 |
Application of multiple-gene stool DNA test in screening for early colorectal cancer |
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| Affiliation: | Anorectal Surgery, the Third Peoples Hopital of Hangzhou, Hangzhou, Zhejiang 310009, China |
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| Abstract: | Objective To study the application of joint detection of feces sFRP2, Vimentin and HPP1 gene methylation in screening for early colorectal cancer. Methods Sixty patients with colorectal cancer admitted to the Third People's Hospital of Hangzhou were recruited in the colorectal cancer group. A non-colorectal cancer group(90 cases) was composed of 60 patients with adenomatous polyps and 30 normal healthy people. The stool samples were collected in early morning to extract stool DNA, And DNA was then modified with bisulfite, methylation-specific PCR was performed to detect the methylation status of sFRP2, Vimentin and HPP1 genes, and their relationship with the clinicopathological features of colorectal cancer was analyzed, and the diagnostic sensitivity and specificity of the three genes combined detection was compared. Results Among colorectal cancer patients, in the test of single gene methylation the sensitivity for sFRP2, Vimentin and HPP1 were 46.7%, 43.3%, 53.3%,respectively; and the specificity for sFRP2, Vimentin and HPP1 was 73.3%, 75.6%, 76.7% respectively; the combined test group had 3 genes One of the genes was positive for methylation expression. The sensitivity was 83.3% and the specificity was 46.7% which was higher than that of sFRP2, Vimentin and single gene test alone. The methylation status of the three genes was not related to the gender, age, tumor site, lymph node metastasis and TNM stage of colorectal cancer patients(all P>0.05). Conclusion The incidence of abnormal methylation of sFRP2, Vimentin and HPP1 genes in fecal DNA of colorectal cancer patients is significantly higher than that of non-colorectal cancer patients. The combined test of stool DNA in screening for colorectal cancer is superior to single gene test in early stage of colorectal cancer It is of great significance in screening applications. |
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