结直肠癌患者血浆SEPT9基因甲基化检测的研究
Clinical significance of plasma methylated SEPT9 gene test for colorectal cancer
目的 探讨血浆Septin 9(SEPT9)基因甲基化检测对结直肠癌的临床意义.方法 回顾性研究.2016至2017年复旦大学附属华山医院选择研究对象分为结直肠癌组(结肠癌65例,直肠癌19例)、癌前病变组(结直肠腺瘤50例)和对照组(20名健康体检者).采用荧光PCR法检测外周血浆SEPT9基因甲基化状态.统计学方法采用卡方检验.结果 结直肠癌组患者SEPT9基因甲基化阳性率为63.1%(53/84例),显著高于癌前病变组10%(5/50例)(χ2=35.993,P=0.000),对照组中未检出.SEPT9基因甲基化检测的敏感度为63.1%(53/84例),联合癌胚抗原(CEA)检测的敏感度为75%(63/84例).ROC曲线分析,SEPT9基因甲基化检测AUC为0.828,高于CEA检测结果(0.795).SEPT9基因甲基化在结直肠癌Ⅰ~Ⅱ期和Ⅲ~Ⅳ期患者检测阳性率分别为51.4%(19/37例)和72.3%(34/47例)(χ2=3.917,P=0.048),与患者年龄、性别和癌变部位无关.结论 血浆SEPT9基因甲基化检测可能有助于结直肠癌早期诊断,且与结直肠癌进展有关.
更多Objective To investigate the clinical significance of plasma methylated Septin 9 (SEPT9)gene test for colorectal cancer(CRC).Methods Clinical data of this retrospective study were obtained from Huashan Hospital of Fudan University(2016-2017).The subjects were divided into three groups,84 patients in CRC group,50 patients with adenoma in precancerous group,and 20 cases as healthy controls.A fluorescent PCR assay was used to analyze SEPT 9 methylation in DNA extracted from plasma. Chi square test was used for statistical analysis.Results The positive incidence of SEPT9 gene methylation in plasma was 63.1%(53/84)in CRC group,significantly higher than 10%(5/50)in precancerous group (χ2=35.993, P<0.001), and undetectable in healthy group.The sensitivity of the methylated SEPT9 gene test was 63.1%(53/84), and the sensitivity of a joint detection combined with carcinoembryonic antigen(CEA)was 75%(63/84).The receiver operating characteristic curve(ROC)showed that methylated SEPT9 gene test had 0.828 in the area under the curve(AUC),higher than 0.795 in the AUC of CEA test.In CRC patients,51.4%(19/37)in the stage Ⅰ-Ⅱand 72.3%(34/47)in the stage Ⅲ-Ⅳ were positive for methylated SEPT9 gene test(χ2=3.917, P<0.05).There were no significant differences in gender,age and primary tumor site.Conclusion The SEPT9 gene methylation in plasma is helpful for early screening for CRC,and is associated with CRC progression.
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