粪便中过氧化物酶体增殖物活化受体δ和环氧合酶2mRNA检测在结直肠癌筛查中的研究

Detection of fecal peroxisome proliferator-activated receptor δ and cyclooxygenase 2 mRNA in screening of colorectal cancer

目的探讨粪便过氧化物酶体增殖物活化受体δ（PPAR-δ）和环氧合酶2（COX-2）mRNA检测在结直肠癌筛查中的价值。方法收集51例结直肠癌患者术前粪便和21例健康志愿者的粪便，运用实时荧光定量PCR方法检测粪便中PPAR-δ和COX-2mRNA水平，评估其对结直肠癌的诊断价值。结果PPAR-δ和COX-2mRNA在结直肠癌患者中的检出率均明显高于健康人群[70．6％（36／51）比33．3％（7／21），74．5％（38／51）比14．3％（3／21），均P〈0．01]。在阳性对照基因ACTBmRNA检测为阳性的47例结直肠癌患者和19例健康志愿者中，PPAR．8mRNA、COX-2mRNA、PPAR-δ与COX-2mRNA联合检测诊断结直肠癌的敏感性分别为76．6％（36／47）、80．9％（38／47）和91．5％（43／47），特异性分别为63．2％（12／19）、84．2％（16／19）和89．5％（17／19），联合检测的敏感性和特异性明显高于单独检测。结论粪便中PPAR-δ和COX-2mRNA检测对结直肠癌有较好的筛查价值，联合PPAR-δ与COX-2检测的筛查价值优于单个基因检测。

Objective To evaluate the detection of fecal PPAR-δ and COX-2 mRNA in screening of colorectal cancer. Methods Fifty-one patients with colorectal cancer and 21 healthy controls were included in this study. Total RNA was isolated from the fecal samples. Expression of PPAR-δ and COX-2 mRNA was determined by RT-PCR, and its value in screening of colorectal cancer was investigated. Results The positive detection rate of fecal PPAR-δ and COX-2 mRNA in colorectal cancer patients was significantly higher than that in healthy controls. In 47 colorectal cancer patients and 19 healthy controls with positive fecal ACTB mRNA expression, the sensitivity of fecal PPAR-δ mRNA, COX-2 mRNA and PPAR-δ mRNA plus COX-2 mRNA detection in diagnosing colorectal cancer was 76.6% （36/47）, 80.9% （38/47） and 91.5% （43/47） respectively ; the specificity was 63.2% （12/19）, 84.2% （16/19） and 89.5% （17/19） respectively. Conclusion The combination detection of fecal PPAR-δ and COX-2 mRNA is effective in screening human eolorectal cancer and is better than detection of single marker alone.