腹腔镜胃癌根治术患者外周血Septin9基因甲基化检测及其临床意义

Detection and clinical significance of methylated Septin 9 in peripheral blood of patients undergoing laparoscopic radical gastrectomy for gastric cancer

目的:探讨腹腔镜胃癌根治术患者外周血Septin9基因甲基化(mSEPT9)检测及其临床意义。方法:选取福建医科大学附属第二医院2018年2月至2021年2月40例腹腔镜胃癌根治术患者为观察组,40例健康人群为对照组,抽取外周静脉血进行Septin9基因甲基化及癌胚抗原(CEA)监测,分析其术前、术后水平的变化。结果:术前观察组mSEPT9阳性率高于对照组阳性率[67.5%(27/40)比5.0%(2/40),χ^(2)=13.268,P<0.05];术前观察组CEA阳性率高于对照组阳性率[32.5%(13/40)比2.5%(1/40),χ^(2)=8.385,P<0.05],术前胃癌患者外周血mSEPT9检测阳性率高于CEA阳性率[67.5%(27/40)比32.5%(13/40),χ^(2)=5.352,P<0.05];观察组术前mSEPT9阳性共27例,术后4周外周血mSEPT9检测阳性6例,转阴率77.8%,术后随访1年8例复发,复发病例监测mSEPT9阳性率高于CEA阳性率[75.0%(6/8)比37.5%(3/8),χ^(2)=6.263,P<0.05]。结论:外周血septin9基因甲基化检测,可作为一种有效、无创的胃癌筛查、评估手术疗效及监测复发的方法。

Objective To investigate the detection and clinical significance of methylated Septin 9(mSEPT9)in peripheral blood of patients undergoing laparoscopic radical gastrectomy for gastric cancer.Methods Forty patients with laparoscopic radical gastrectomy for gastric cancer in the Second Affiliated Hospital of Fujian Medical University from February 2018 to February 2021 were selected as the observation group,and 40 healthy people were selected as the control group.Peripheral venous blood samples were collected for methylated Septin 9 and carcino-embryonic antigen(CEA)monitoring.The changes of preoperative and postoperative levels were analyzed.Results The positive rate of mSEPT9 in the observation group was higher than that in the control group[67.5%(27/40)vs.5.0%(2/40),χ^(2)=13.268,P<0.05].The positive rate of CEA in the observation group was higher than that in the control group[32.5%(13/40)vs.2.5%(1/40),χ^(2)=8.385,P<0.05].The positive rate of mSEPT9 in peripheral blood of gastric cancer patients before surgery was higher than that of CEA[67.5%(27/40)vs.32.5%(13/40),χ^(2)=5.352,P<0.05];In the observation group,27 cases were positive for mSEPT9 before operation,6 cases were positive for mSEPT9 in peripheral blood at 4 weeks after operation,with a negative conversion rate of 77.8%.Eight cases had recurrence after 1 year follow-up,and the positive rate of mSEPT9 was higher than that of CEA[75.0%(6/8)vs.37.5%(3/8),χ^(2)=6.263,P<0.05].Conclusion Methylated Septin 9 detection in peripheral blood can be used as an effective and non-invasive method for screening gastric cancer,evaluating surgical efficacy and monitoring recurrence.