SDC2和SFRP2甲基化状态在结直肠癌筛查中的价值

中华消化内镜杂志 Pub Date : 2019-06-20 DOI:10.3760/CMA.J.ISSN.1007-5232.2019.06.009

Yu Bai, L. Jing, Q. Kang, Yushu Chen, Wang Meicong, P. Jin, Yiqun Mi, R. Gao, H. Qin, Zhaoshen Li, N. Qin, J. Sheng

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The promoter methylation of fecal SDC2 and SFRP2 genes was detected by methylation-specific PCR (MSP) and compared with single gene methylation and the fecal immunochemical tests (FIT) to evaluate its sensitivity and specificity. \n \n \nResults \nThe stool sample analysis showed that the sensitivity of combined detection of SDC2 and SFRP2 in CRC group was 97.73% (129/132) , which was significantly higher than those of the single gene SDC2 test [70.45% (93/132) , P=0.000], single SFRP2 test [81.82% (108/132) , P=0.000] and FIT [69.70% (92/132) , P=0.000]. In adenoma group, the sensitivity of combined detection of SDC2 and SFRP2 was 57.89% (22/38) , which was significantly higher than those of the single gene SDC2 test [15.79% (6/38) , P=0.000] and FIT [21.05% (8/38) , P=0.021], with no significant difference compared with that of SFRP2 test [47.37% (18/38) , P=0.358]. In healthy group, the specificity of combined detection of SDC2 and SFRP2 was 98.68% (150/152) , with no significant difference compared with those of single gene SDC2 test [100.00% (152/152) , P=0.156], single SFRP2 test [98.68% (150/152) , P=1.000] or FIT [95.39% (145/152) , P=0.091]. 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引用次数: 3

摘要

目的探讨粪便DNA中SDC2和SFRP2基因启动子甲基化在大肠癌筛查中的价值。方法选取海军医科大学长海医院、同济大学第十人民医院、中国人民解放军总医院第七医学中心的粪便标本。2018年3月至2018年12月收集的500份粪便样本被分为CRC组（132份CRC）、腺瘤组（38份晚期腺瘤）、健康组（152名健康人）、干扰组（178例良性结直肠疾病或其他非结直肠肿瘤）和阴性组（330例由健康组和干扰组组成）。通过甲基化特异性PCR（MSP）检测粪便SDC2和SFRP2基因的启动子甲基化，并与单基因甲基化和粪便免疫化学测试（FIT）进行比较，以评估其敏感性和特异性。结果CRC组SDC2和SFRP2联合检测的敏感性为97.73%（129/132），显著高于单基因SDC2检测[70.45%（93/132）、单基因SFRP2检测[81.82%（108/132）和FIT[69.70%（92/132），SDC2和SFRP2联合检测的敏感性为57.89%（22/38），显著高于单基因SDC2试验[15.79%（6/38），P=0.000]和FIT[21.05%（8/38），P=0.021]，与SFRP2试验[47.37%（18/38），P=0.358]相比无显著差异，与单基因SDC2试验[100.00%（152/152），P=0.156]、单基因SFRP2试验[98.68%（150/152）、P=1.000]或FIT[95.39%（145/152）和P=0.091]相比无显著差异。干扰组和阴性组两个基因联合检测的特异性分别为90.45%（161/178）和94.24%（311/330），分别显著高于FIT的73.03%（130/178，P=0.000）和83.33%（275/330，P=0.0000）。结论SDC2和SFRP2甲基化联合检测优于单基因检测，其对CRC和侵袭性腺瘤的敏感性和鉴别良恶性病变的特异性均高于FIT，具有潜在的应用价值。关键词：基因成分；DNA；粪便；甲基化；结直肠肿瘤；SDC2/SFRP2

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Value of the methylation status of SDC2 and SFRP2 for colorectal cancer screening

Objective To explore the value of methylation of SDC2 and SFRP2 genes promoter in fecal DNA for colorectal cancer (CRC) screening. Methods All stool samples were enrolled from Changhai Hospital of Naval Medical University, the Tenth People′s Hospital of Tongji University and the Seventh Medical Center of Chinese People′s Liberation Army General Hospital. A total of 500 stool samples collected from March 2018 to December 2018 were allocated to CRC group (132 CRCs) , adenoma group (38 advanced adenomas) , healthy group (152 healthy individuals) , interferential group (178 cases of benign colorectal disease or other non-colorectal tumors) and negative group (330 cases composed of healthy group and interferential group) . The promoter methylation of fecal SDC2 and SFRP2 genes was detected by methylation-specific PCR (MSP) and compared with single gene methylation and the fecal immunochemical tests (FIT) to evaluate its sensitivity and specificity. Results The stool sample analysis showed that the sensitivity of combined detection of SDC2 and SFRP2 in CRC group was 97.73% (129/132) , which was significantly higher than those of the single gene SDC2 test [70.45% (93/132) , P=0.000], single SFRP2 test [81.82% (108/132) , P=0.000] and FIT [69.70% (92/132) , P=0.000]. In adenoma group, the sensitivity of combined detection of SDC2 and SFRP2 was 57.89% (22/38) , which was significantly higher than those of the single gene SDC2 test [15.79% (6/38) , P=0.000] and FIT [21.05% (8/38) , P=0.021], with no significant difference compared with that of SFRP2 test [47.37% (18/38) , P=0.358]. In healthy group, the specificity of combined detection of SDC2 and SFRP2 was 98.68% (150/152) , with no significant difference compared with those of single gene SDC2 test [100.00% (152/152) , P=0.156], single SFRP2 test [98.68% (150/152) , P=1.000] or FIT [95.39% (145/152) , P=0.091]. Specificities of combined detection of two genes in interferential and negative groups were 90.45% (161/178) and 94.24% (311/330) , which were significantly higher than 73.03% (130/178, P=0.000) and 83.33% (275/330, P=0.000) of FIT, respectively. Conclusion The combined detection test of methylation of SDC2 and SFRP2 is superior to single gene test, whose sensitivity of CRC and aggressive adenoma and specificity of distinguishing benign and malignant lesions are higher than FIT, which has potential application value. Key words: Gene components; DNA; Feces; Methylation; Colorectal neoplasms; SDC2/SFRP2

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来源期刊

中华消化内镜杂志

CiteScore

0.10

自引率

0.00%

发文量

7555

期刊介绍： Chinese Journal of Digestive Endoscopy is a high-level medical academic journal specializing in digestive endoscopy, which was renamed Chinese Journal of Digestive Endoscopy in August 1996 from Endoscopy. Chinese Journal of Digestive Endoscopy mainly reports the leading scientific research results of esophagoscopy, gastroscopy, duodenoscopy, choledochoscopy, laparoscopy, colorectoscopy, small enteroscopy, sigmoidoscopy, etc. and the progress of their equipments and technologies at home and abroad, as well as the clinical diagnosis and treatment experience. The main columns are: treatises, abstracts of treatises, clinical reports, technical exchanges, special case reports and endoscopic complications. The target readers are digestive system diseases and digestive endoscopy workers who are engaged in medical treatment, teaching and scientific research. Chinese Journal of Digestive Endoscopy has been indexed by ISTIC, PKU, CSAD, WPRIM.