早期结直肠癌粪便基因筛查与中医证型的相关性研究

Study on the correlation between fecal genetic screening of early colorectal cancer and traditional Chinese medicine syndrome types

目的:探析早期结直肠癌黏结蛋白聚糖2(syndecan2,SDC2)粪便基因检测与中医证型的相关性。方法:依据纳入标准选取2021年10月—2022年3月就诊的结直肠癌(colorectal cancer,CRC)高风险患者200例,按中医辨证分为湿热蕴结、瘀毒内阻、脾虚气滞和其他证型,通过样本预处理研磨离心、核酸富集磁珠法、重亚硫酸盐修饰、荧光定量PCR检测等实验处理检测各组SDC2结果,并分析各证型与结直肠癌SDC2粪便基因检测阳性结果的相关性。结果:(1)对200例早期结直肠癌高风险人群进行中医证候分型,其中湿热蕴结证(94例)、瘀毒内阻证(51例)、脾虚气滞证(36例)、其他证型(19例);(2)早期结直肠癌各证型SDC2粪便基因检测按阳性率大小排列依次是湿热蕴结(30.85%)>瘀毒内阻(23.53%)>脾虚气滞(11.11%)>其他证型(5.26%),差异具有统计学意义(P<0.05);(3)各组间Ct值阳性水平湿热蕴结(33.61)<瘀毒内阻(36.34)<脾虚气滞(37.45)。结论:早期结直肠癌SDC2粪便基因检测与中医证型存在相关性,且湿热蕴结证与早期结直肠癌关系最为密切,可为结直肠癌早期筛查提供中医证型依据。

Objective:To explore the correlation between fecal gene detection of syndecan2(SDC2)and TCM syndrome types in early colorectal cancer.Methods:Based on inclusion criteria,200 high-risk patients with colorectal cancer(CRC)were selected from October 2021 to March 2022.According to TCM syndrome differentiation,these patients were classified into accumulation of dampness-heat syndrome,internal obstruction of blood-stasis and toxin syndrome,spleen deficiency and Qi stagnation syndrome,etc.SDC2 results of each group were detected by sample preprocessing grinding centrifugation,magnetic bead enrichment of nucleic acid,heavy sulfite modification,fluorescence quantitative PCR detection,and the correlation between each syndrome type and positive results of SDC2 fecal gene detection of CRC was analyzed.Results:(1)200 patients with high-risk of early CRC were classified according to TCM syndromes,including accumulation of dampness-heat syndrome(94 cases),internal obstruction of blood-stasis and toxin syndrome(51 cases),spleen deficiency and Qi stagnation syndrome(36 cases),and other syndromes(19 cases);(2)according to the positive rate of SDC2 gene detection in feces of all syndrome types of early CRC,the sequence was accumulation of dampness-heat syndrome(30.85%)>internal obstruction of blood-stasis and toxin syndrome(23.53%)>spleen deficiency and Qi stagnation syndrome(11.11%)>other syndromes(5.26%),and the difference was statistically significant(P<0.05);(3)the positive Ct value of each group was as follows:accumulation of dampness-heat syndrome(33.61)<internal obstruction of blood-stasis and toxin syndrome(36.34)<spleen deficiency and Qi stagnation syndrome(37.45).Conclusion:SDC2 fecal gene detection of early CRC is correlated with TCM syndrome types,and the syndrome of accumulation of dampness-heat is most closely related to early CRC,which can provide TCM syndrome types basis for early screening of CRC.