p73基因甲基化和CEA联合检测在结直肠癌诊断中的意义

目的探讨p73基因甲基化和癌胚抗原(carcinoembryonic antigen,CEA)检测在结直肠癌诊断中的临床意义。方法受检者分为三组,即结直肠癌组(A组)64例,结直肠瘤组(B组)78例,健康对照组(C组)142例。另将A、B组患者病灶组织以外5 cm以上,病理组织学诊断为正常粘膜组织的97例标本纳入组织对照组(D组)。采用甲基化特异性PCR(methylation specific PCR,MSP)行组织、血浆p73基因甲基化测定,并检测血清CEA,比较单独和联合检测对结直肠癌诊断的敏感性和特异性,以及联合检测对结直肠癌诊断接受者的工作特征曲线(receiver operatingcharacteristics,ROC)分析。结果组织与血浆p73基因甲基化阳性率的差异在A、B两组中均无统计学意义(P0.05);三种检测方法的阳性率在对照组-瘤-癌序列中均逐渐升高(P0.01);联合三种检测方法对结直肠癌诊断的灵敏性高于两两方法的联合检测(P0.05),但特异性的下降无统计学意义(P0.05);联合三种检测方法诊断结直肠癌的ROC曲线下面积(area under the curve,AUC)为0.896,高于三种检测方法中任意两两联合的AUC(0.828,0.837,0.850)。结论联合组织、血浆p73基因甲基化测定及血清CEA对结直肠癌的诊断有重要的临床意义。

Clinical significance of combined of p73 gene methylation and serum CEA in diagnosis of colorectal cancer

Objective To explore the diagnostic value of p73 gene methylation and serum CEA in colorectal cancer Methods The subjects were divided into three groups,64 cases in colorectal cancer group (group A),78 cases in colorectal tumor group (group B),142 cases in health control group (group C).In addition,97 cases in the control group of organization more than 5 cm outside the lesion (group D).Using methylation specific PCR (MSP) for determination of p73 gene methylation in tissue samples and plasma,with all cases detection of serum CEA.Joint organization and determination of p73 gene methylation of plasma and serum CEA,and draw the result of the joint detection receiver operating characteristics curve(ROC).Results The p73 gene methylation positive rate of tissue and plasma was closely in group A and group B (P＞0.05);Positive rate of three detection methods were increased in the sequence from the control group to the colorectal adenoma group and colorectal cancer group (P＜0.01);The sensitivity of combined with three methods in diagnosis was of colorectal cancer was superior than combined with two methods (P＜0.05),but had no apparent decline in the specificity (P＞0.05).Area under the ROC curve that combination of measurement p73 gene methylation of tissue and plasma with serum CEA in the diagnosis of colorectal cancer was 0.896,higher than combination any two methods in the three detection methods (0.828,0.837,0.850).Conclusion Combination p73 gene methylation of tissue and plasma with serum CEA has important clinical significance in the diagnosis of colorectal cancer.