粪便SDC2基因甲基化检测联合结肠镜在早期结直肠癌筛查中的意义

目的探讨粪便SDC2基因甲基化检测联合结肠镜在早期结直肠癌(CRC)筛查中的意义。方法选择2018年1月-2019年10月在深圳市宝安区中心医院体检的1 000例体检者作为研究对象,使用试剂盒分别检测粪便SDC2基因甲基化和血浆SEPT9基因甲基化,对两者任一结果为阳性者再行结肠镜检查。比较SDC2和SEPT9基因甲基化检测的阳性率以及两者联合结肠镜对进展性腺瘤和CRC的检出率。结果在1 000例筛查对象中,粪便SDC2基因甲基化检测阳性率明显高于血浆SEPT9基因甲基化〔18.10%(181/1 000)比9.80%(98/1 000)〕,差异有统计学意义(P<0.05);粪便SDC2基因甲基化检测联合结肠镜对进展性腺瘤和CRC的检出率均明显高于血浆SEPT9基因甲基化检测联合结肠镜筛查〔进展性腺瘤检出率:2.50%(25/1 000)比1.00%(10/1 000),CRC检出率:1.50%(15/1 000)比0.50%(5/1 000)〕,差异均有统计学意义(均P<0.05)。结论粪便SDC2基因甲基化检测是一种简单无创的CRC筛查新技术,患者接受程度更高,能够避免大规模肠镜筛查带来的弊端,联合结肠镜检测可作为CRC早期筛查的首选策略。

Significance of fecal SDC2 gene methylation detection combined with colonoscopy in screening for early colorectal cancer

Objective To explore the significance of stool SDC2 gene methylation detection combined with colonoscopy for early screening of colorectal cancer (CRC).Methods The 1 000 medical examiners in Shenzhen Bao’an Central Hospital from January 2018 to October 2019 were selected as the research objects.The stool SDC2 and plasma SEPT9 gene methylation tests were performed using test kit,and colonoscopy was performed for those who were positive for either test.The positive rates of SDC2 and SEPT9 gene methylation tests and the detection rates for progressive adenoma and CRC of the two methods combined with colonoscopy were compared.Results Among the 1 000 medical examiners,the positive rate of fecal SDC2 gene methylation was significantly higher than that of plasma SEPT9 gene methylation 18.10% (181/1 000) vs.9.80% (98/1 000),P < 0.05].The detection rates of stool SDC2 gene methylation combined with colonoscopy for progressive adenoma and CRC were significantly higher than those of plasma SEPT9 gene methylation progressive adenoma:2.50% (25/1 000) vs.1.00% (10/1 000),CRC:1.50% (15/1 000) vs.0.50% (5/1 000)],with significant difference(all P < 0.05).Conclusion Fecal SDC2 gene methylation detection is a simple and non-invasive new CRC screening technique,with higher acceptance for patients,can avoid the disadvantages of large-scale enteroscopy screening,and fecal SDC2 gene methylation combined with colonoscopy can be the preferred strategy for early screening of CRC.