| 王小军,刘 蕾,柳 新,等.粪便多配体聚糖2基因甲基化联合结肠镜在结直肠癌中的检测效能[J].中国肿瘤,2023,32(7):557-562. |
| 粪便多配体聚糖2基因甲基化联合结肠镜在结直肠癌中的检测效能 |
| Fecal SDC-2 Gene Methylation Assay Assists Colonoscopy to Improve the Detection Efficiency of Colorectal Cancer |
| 投稿时间：2022-12-22 |
| DOI：10.11735/j.issn.1004-0242.2023.07.A011 |
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| 中文关键词: 多配体聚糖2基因 甲基化 结直肠癌 进展期癌前病变 早癌 结肠镜 |
| 英文关键词:syndecan-2 methylation colorectal cancer advanced precancerous lesions early-stage cancer colonoscopy |
| 基金项目:松江区科学技术委员会基金（NCT0397747） |
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| 中文摘要: |
| 摘 要：［目的］ 探讨粪便多配体聚糖2基因甲基化（methylated syndecan-2，mSDC2）检测在结直肠癌（colorectal cancer，CRC）和进展期癌前病变（advanced precancerous lesions，APL）中的诊断价值，并研究mSDC2联合结肠镜检查是否提高结直肠癌的检测效能。［方法］ 根据结肠镜检查和/或最终病理诊断，155例受试者分为3组：CRC组（44例）、APL组（67例）和对照组（44例）。每位研究对象均进行结肠镜检查并收集一份粪便标本进行实时定量特异性聚合酶链反应检测分析mSDC2水平。采用配对卡方检验比较mSDC2、结肠镜检查及两者联合后的灵敏度和特异度差异。［结果］ CRC组和APL组以及APL组和对照组mSDC2的Ct值差异均有统计学意义（P均<0.01）。CRC组和APL组mSDC2检测灵敏度差异有统计学意义（P<0.01）。APL组中高级别上皮内瘤变（high grade intraepithelial neoplasia，HGIEN）患者和非HGIEN患者mSDC2的Ct值和灵敏度差异均有统计学意义（P均<0.05）。mSDC2检测在APL、HGIEN、HGIEN+Ⅰ期CRC和Ⅱ~Ⅳ期CRC 各组中灵敏度分别为52.2%（35/67）、80.0%（12/15）、83.9%（26/31）和92.9%（26/28）。mSDC2在HGIEN组、HGIEN+Ⅰ期CRC组和M~T1 CRC组灵敏度显著高于结肠镜（P均<0.01）。mSDC2+结肠镜在APL组、HGIEN组、HGIEN+Ⅰ期CRC组和M~T1 CRC组的灵敏度显著高于结肠镜（P均<0.01）。［结论］ 粪便mSDC2在CRC检测效能和结肠镜相似，在早癌优于结肠镜，联合结肠镜检查可显著提高结直肠早癌的检测效能。 |
| 英文摘要: |
| Abstract：［Purpose］ To investigate the diagnostic value of methylated syndecan-2(mSDC2) assay in colo-rectal cancer(CRC) and advanced precancerous lesions(APL)， and the effect on colonoscopic detection efficiency of CRC. ［Methods］ A total of 155 patients who underwent colonoscopy and mSDC2 assay were enrolled in the study. The mSDC2 was detected by real-time quantitative methylation-specific polymerase chain reaction in fecal samples. According to pathological results there were 44 cases of CRC(CRC group)， 67 cases of APL (APL group) and 44 subjects without of CRC or APL (control group). The sensiti-vity and specificity of mSDC2， colonoscopy and their combination were compared by McNemar test. ［Results］ There were significant differences in Ct value of mSDC2 between CRC group and APL group (P<0.01). There was significant difference in the sensitivity of mSDC2 in detection of CRC group and APL group(P<0.01). In APL group， the Ct value and sensitivity of mSDC2 were different between high grade intraepithelial neoplasia patients and others(all P<0.05). The sensitivity of mSDC2 in detection of APL， HGIEN， HGIEN+stage Ⅰ CRC and stage Ⅱ~Ⅳ CRC was 52.2%(35/67)， 80.0%(12/15)， 83.9%(26/31) and 92.9%(26/28) respectively. The sensitivity of mSDC2 in diagnosis of HGIEN， HGIEN+stage Ⅰ CRC and M~T1 CRC was significantly higher than that of colonoscopy(all P<0.01). The sensitivity of mSDC2+colonoscopy in diagnosis of APL， HGIEN， HGIEN+stage Ⅰ CRC and M~T1 CRC was significantly higher than that of colonoscopy(all P<0.01). ［Conclusion］ The detection efficiency of fecal mSDC2 is similar to that of colonoscopy in CRC， but superior to that of colonoscopy in early-stage cancer. The combination mSDC2 assay with colonoscopy may be more sensitive in diagnosis of early-stage CRC. |
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