【摘要】：目的探討糞便ECAD甲基化聯(lián)合隱血在結直腸癌(CRC)中的診斷價值。方法收集50例健康體檢者、50例結直腸良性病變者、50例CRC患者的糞便標本。利用甲基化特異性PCR(MSP)的方法檢測糞便中ECAD基因的甲基化情況,根據(jù)腸鏡病理診斷進行驗證,比較糞便ECAD甲基化率、糞便潛血實驗(FOBT)及兩者聯(lián)合對CRC診斷的敏感性及特異性,并進行統(tǒng)計學分析。結果 CRC患者糞便ECAD甲基化率(78%)明顯高于健康體檢者(16%)和結直腸良性病變者(26%);同時,CRC患者FOBT陽性率(64%)亦明顯高于健康體檢者(2%)和結直腸良性病變者(26%),差異有統(tǒng)計學意義(P0.001)。糞便ECAD甲基化率與CRC患者腫瘤數(shù)目(P=0.048)、病理分級(P=0.006)、TNM分級(P=0.002)及淋巴結轉移(P=0.002)密切相關。CRC患者糞便FOBT敏感度為64%(95%CI:49.1%~76.7%),特異度為86%(95%CI:77.3%~91.9%);而ECAD敏感度為78%(95%CI:63.7%~88.0%),特異度為79%(95%CI:69.5%~86.2%)。ROC曲線分析提示ECAD的ROC曲線下面積(AUC)為0.795(95%CI為0.716~0.874),略高于FOBT的AUC(0.750,95%CI:0.661~0.839),而兩種聯(lián)合的AUC為0.806(95%CI:0.728~0.884),診斷效能最高。結論糞便ECAD基因甲基化的檢測是早期診斷CRC的有效方法,其聯(lián)合FOBT能有效提高診斷效能。
[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.
【作者單位】： 廣東省惠州市中心人民醫(yī)院腫瘤內(nèi)科;
【分類號】：R735.34

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