联合检测粪便ECAD基因甲基化和隐血在结直肠癌诊断中的价值

发布时间：2018-11-27 18:47

【摘要】：目的探讨粪便ECAD甲基化联合隐血在结直肠癌(CRC)中的诊断价值。方法收集50例健康体检者、50例结直肠良性病变者、50例CRC患者的粪便标本。利用甲基化特异性PCR(MSP)的方法检测粪便中ECAD基因的甲基化情况,根据肠镜病理诊断进行验证,比较粪便ECAD甲基化率、粪便潜血实验(FOBT)及两者联合对CRC诊断的敏感性及特异性,并进行统计学分析。结果 CRC患者粪便ECAD甲基化率(78%)明显高于健康体检者(16%)和结直肠良性病变者(26%);同时,CRC患者FOBT阳性率(64%)亦明显高于健康体检者(2%)和结直肠良性病变者(26%),差异有统计学意义(P0.001)。粪便ECAD甲基化率与CRC患者肿瘤数目(P=0.048)、病理分级(P=0.006)、TNM分级(P=0.002)及淋巴结转移(P=0.002)密切相关。CRC患者粪便FOBT敏感度为64%(95%CI:49.1%~76.7%),特异度为86%(95%CI:77.3%~91.9%);而ECAD敏感度为78%(95%CI:63.7%~88.0%),特异度为79%(95%CI:69.5%~86.2%)。ROC曲线分析提示ECAD的ROC曲线下面积(AUC)为0.795(95%CI为0.716~0.874),略高于FOBT的AUC(0.750,95%CI:0.661~0.839),而两种联合的AUC为0.806(95%CI:0.728~0.884),诊断效能最高。结论粪便ECAD基因甲基化的检测是早期诊断CRC的有效方法,其联合FOBT能有效提高诊断效能。
[Abstract]:Objective to evaluate the diagnostic value of fecal ECAD methylation combined with occult blood in (CRC) of colorectal cancer. Methods stool specimens of 50 healthy persons, 50 patients with colorectal benign lesions and 50 patients with CRC were collected. The methylation of ECAD gene in feces was detected by methylation specific PCR (MSP). The methylation rate of ECAD in feces was compared according to the pathological diagnosis of enteroscopy. The sensitivity and specificity of fecal occult blood test (FOBT) and its combination in the diagnosis of CRC were analyzed statistically. Results the fecal ECAD methylation rate in CRC patients (78%) was significantly higher than that in healthy controls (16%) and colorectal benign lesions (26%). The positive rate of FOBT in CRC patients (64%) was significantly higher than that in healthy controls (2%) and colorectal benign lesions (26%). The difference was statistically significant (P0. 001). The rate of ECAD methylation in feces and the number of tumors in patients with CRC (P0. 048), pathological grade (P0. 006), The sensitivity of stool FOBT in CRC patients was 64% (95 CI: 49.1%) and the specificity was 86% (95 CI: 77.3%). The sensitivity of ECAD is 78%. The area under the ROC curve of ECAD was 0.795 (95%CI = 0.716 ~ 0.874), which was slightly higher than that of FOBT (0.750% CI: 0.661C ~ 0.839), and the area under the ROC curve of ECAD was 0.795 (95%CI = 0.716 ~ 0.874), which was slightly higher than that of FOBT (0.750 ~ 9595 CI: 0.661 ~ (0.839). The combined AUC was 0.806 (95%CI:0.728~0.884) and the diagnostic efficiency was the highest. Conclusion the detection of fecal ECAD gene methylation is an effective method for early diagnosis of CRC and its combination with FOBT can effectively improve the diagnostic efficacy.
【作者单位】：广东省惠州市中心人民医院肿瘤内科;
【分类号】：R735.34

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