外周血Septin9基因甲基化检测在胃癌的临床应用价值探讨

Clinical application value of peripheral blood Septin9 gene methylation detection in gastric cancer

目的研究胃癌患者外周血中Septin9基因甲基化(mSEPT9)异常表达情况,探讨其对胃癌诊断的临床应用意义。方法收集2019年11月至2022年2月在右江民族医学院附属医院行外周血mSEPT9检测患者,经筛选纳入胃癌组136例,胃炎组30例,无疾病证据组60例。分析各组外周血mSeptin9表达情况,探讨外周血mSEPT9检测对临床诊断胃癌的可行性;并比较分析mSEPT9检测与消化道肿瘤血清学指标CEA、CA199、AFP的诊断效能。结果胃癌组外周血mSEPT9阳性率高于胃炎组和无疾病证据组(50.74%vs 26.67%vs 3.33%),差异具有统计学意义(P<0.05),特异度和灵敏度分别为88.89%和50.74%,ROC曲线下面积为0.716。胃癌患者外周血mSeptin9检测诊断效能高于消化道肿瘤血清学指标CEA、CA199、AFP,差异具有统计学意义(P<0.05)。mSEPT9表达差异与胃癌临床分期有关,与其他病理参数无关。mSEPT9与胃癌不良预后有关。结论外周血mSEPT9检测对胃癌的诊断和判断预后具有一定的临床价值。

Objective To investigate the abnormal expression of the Septin9 gene methylation(mSEPT9)in the peripheral blood of patients with gastric cancer(GC),and to explore its clinical significance in GC diagnosis.Methods Patients who underwent peripheral blood mSEPT9 tests at the Affiliated Hospital of Youjiang Medical University for Nationalities from November 2019 to February 2022 were collected.A total of 136 patients with GC,30 patients with gastritis,and 60 patients with no evidence of disease were included after screening.The expression of mSEPT9 in the peripheral blood of each group was analyzed to explore the feasibility of mSEPT9 detection in the clinical diagnosis of GC.The diagnostic efficacy of mSEPT9 detection was compared with the serological indicators of gastrointestinal tumors,including CEA,CA199,AFP.Results The positive rate of mSEPT9 in the peripheral blood of the GC group was higher than in the gastritis and no disease evidence groups(50.74%vs.26.67%vs.3.33%),and the difference was statistically significant(P<0.05).The specificity and sensitivity were 88.89%and 50.74%,respectively,with an area under the ROC curve of 0.716.The diagnostic efficacy of mSEPT9 detection in the peripheral blood of GC patients was higher than that of serological indicators(CEA,CA199,AFP),and the difference was statistically significant(P<0.05).Differential mSEPT9 expression was related to the clinical stage of GC but not to other pathological parameters.mSEPT9 was associated with a poor prognosis in GC.Conclusion Peripheral blood mSEPT9 detection has certain clinical value in the diagnosis and prognosis assessment of GC.