血浆SEPT9基因甲基化在结直肠癌根治术后复发监测中的应用

Application of plasma SEPT9 gene methylation in monitoring the recurrence of colorectal cancer after radical resection

目的分析血浆SEPT9基因甲基化(mSEPT9)在结直肠癌根治术患者术后复发监测中的应用效果。方法选取2014年4月至2018年4月在该院行根治术的154例结直肠癌患者作为研究对象,采用试剂盒检测患者外周血标本中的mSEPT9和癌胚抗原(CEA),并分析mSEPT9与年龄、性别、体质量指数(BMI)、淋巴结转移、发生部位、血管是否侵犯、脉管是否侵犯、TNM分期、术后复发的关系。结果154例结直肠癌患者术前血浆mSEPT9检测阳性率为70.13%(108/154),其中TNMⅠ期阳性率为44.44%(8/18),Ⅱ期阳性率为63.41%(52/82),Ⅲ期阳性率为88.89%(48/54),随着患者TNM分期的提高,血浆mSEPT9检测阳性率也随之升高,且Ⅰ、Ⅱ期患者阳性率均低于Ⅲ期(P<0.05)。淋巴结转移患者血浆mSEPT9检测阳性率为95.89%,明显高于淋巴结未转移患者(46.91%),差异有统计学意义(P<0.05),但是患者术前血浆mSEPT9检测阳性率在不同年龄、性别、BMI、发生部位、血管是否侵犯、脉管是否侵犯间比较,差异无统计学意义(P>0.05)。154例结直肠癌患者术后血浆mSEPT9检测阳性率与术前比较,差异有统计学意义(P<0.05)。术后复发患者的血浆mSEPT9检测阳性率要高于血清CEA检测阳性率(P<0.05)。结论血浆mSEPT9检测不仅可以作为检测结直肠癌患者手术疗效的标准,也可以作为结直肠癌患者术后复发检测的分子标志物。

Objective To explore the application effect of plasma SEPT9 gene methylation(mSEPT9)in monitoring postoperative recurrence of colorectal cancer patients after radical resection.Methods A total of 154 patients with colorectal cancer who underwent radical operation in the hospital from April 2014 to April 2018 were selected as the research objects.The mSEPT9 and carcinoembryonic antigen(CEA)in peripheral blood samples of patients were detected by kit.The correlation between mSEPT9 and age,gender,body mass index(BMI),lymph node metastasis,location,vascular invasion,vessel invasion,TNM stage and postoperative recurrence were analyzed.Results The positive rate of plasma mSEPT9 in 154 patients with colorectal cancer was 70.13%(108/154).The positive rate of TNM stageⅠwas 44.44%(8/18),that of stageⅡwas 63.41%(52/82),and that of stageⅢwas 88.89%(48/54),with the improvement of TNM stage,the positive rate of plasma mSEPT9 increased,and the positive rate of patients with stageⅠandⅡwas lower than that of stageⅢ(P<0.05).The positive rate of plasma mSEPT9 in patients with lymph node metastasis was 95.89%,which was significantly higher than that in patients without lymph node metastasis(46.91%,P<0.05),however,there was no significant difference in the positive rate of mSEPT9 among patients with different age,gender,BMI,location,wether vascular invasion and vessel invasion(P>0.05).The positive rate of plasma mSEPT9 in all 154 patients with colorectal cancer was significantly higher than that before operation(P<0.05).The positive rate of plasma mSEPT9 was higher than that of CEA(P<0.05).Conclusion The detection of plasma mSEPT9 can not only be used as a standard to detect the curative effect of colorectal cancer patients,but also can be used as a molecular marker for the detection of postoperative recurrence of colorectal cancer patients.