粪便SDC2基因甲基化检测在结直肠肿瘤早期检测中的应用价值

Application value of fecal SDC2 gene methylation test in early colorectal tumor diagnosis

目的探讨粪便SDC2基因甲基化检测在结直肠肿瘤早期检测中的价值。方法收集2018年1月-2018年12月收治的134例入组人群的病历资料,观察和比较粪便SDC2基因甲基化和血清癌胚抗原(CEA)两种检测方法对结直肠肿瘤诊断的灵敏度和特异度。结果 134例入组人群中,正常86例,结直肠腺瘤22例,结直肠癌26例。SDC2基因甲基化检测(长安心)阳性45例,阴性89例,血清CEA检测阳性16例,阴性118例。26例结直肠癌中SDC2基因甲基化检测阳性23例(88.46%),血清CEA检测阳性7例(26.92%),SDC2基因甲基化检测灵敏度高于血清CEA检测(P<0.001)。22例腺瘤患者中,SDC2基因甲基化检测阳性高于血清CEA检测(31.82%vs.4.54%,P=0.042)。结论相比血液CEA检测,粪便SDC2基因甲基化检测诊断结直肠癌及癌前病变有较高灵敏度,有待于扩大样本量对结直肠肿瘤早期诊断中价值作深入探讨。

Objective To investigate the value of fecal SDC2 gene methylation test in early colorectal tumor diagnosis. Methods Medical records data of134 enrolled patients were collected from six hospitals from January2018 to December2018. The sensitivity and specificity between fecal SDC2 gene methylation test and serum carcinoembryonic antigen(CEA)test for early colorectal tumor diagnosis were compared. Results Of the134 enrolled cases,86 cases were without colorectal tumors,22 cases with colorectal adenoma,and26 cases with colorectal cancer. Fecal SDC2 gene methylation was detected positive in45 patients and negative in89 patients. Serum CEA was detected positive in16 patients and negative in118 patients. In the26 patients with colorectal cancer,the positive rate of SDC2 gene methylation(88.46%)was higher than that of serum CEA(27.59%),indicating that the sensitivity of SDC2 gene methylation test was higher than that of serum CEA test for patients with colorectal cancer(P<0.001). In the22 patients with colorectal adenoma,the positive rate of SDC2 gene methylation was higher than that of serum CEA(22.73% vs.4.54%,P=0.185). Conclusion Compared with serum CEA test,fecal SDC2 gene methylation test has a higher sensitivity in the diagnosis of colorectal tumor and precancerous lesions,and its role in the early diagnosis of colorectal tumor requires to be investigated in a larger sample size.