摘要
目的探讨腹腔脱落细胞Dickkopf-3(DKK3)基因甲基化在Ⅳ期胃癌病情及预后评估中的临床意义。方法选择2014年1月至2017年12月湖北医药学院附属随州医院诊治的原发性Ⅳ期胃癌患者为研究对象(胃癌组),检测Ⅳ期胃癌患者(胃癌组,n=120)腹腔脱落细胞、外周血和胃良性疾病患者(对照组,n=60)腹腔脱落细胞DKK3基因甲基化并比较其差异,分析胃癌组患者不同临床病理因素中腹腔脱落细胞DKK3基因甲基化的差异,Kaplan-Meier法对胃癌患者腹腔脱落细胞DKK3基因甲基化和未甲基化患者行生存分析。受试者工作特征(ROC)曲线比较腹腔脱落细胞及外周血DKK3诊断胃癌腹膜种植转移敏感度及特异性。胃癌组和对照组患者对比采用t或χ2检验。结果胃癌组患者腹腔脱落细胞DKK3基因甲基化率(73.3%)均显著高于胃癌组患者外周血(60.0%)及对照组患者腹腔脱落细胞(8.3%,χ2=70.303,P<0.05);胃癌组患者腹腔脱落细胞DKK3基因甲基化率在分化程度、肿瘤最大径和淋巴结转移数目的差异均有统计学意义(χ2=4.096、5.507、6.525,P值均<0.05)。胃癌患者中腹腔脱落细胞DKK3基因甲基化的患者中位生存期显著低于未甲基化患者[(13.2±1.4)个月比(16.4±1.7)个月,Log-rank=7.817,P<0.01],差异有统计学意义。腹腔脱落细胞DKK3基因甲基化诊断腹膜种植转移敏感度(0.753)及特异性(0.811)均显著高于外周血DKK3基因甲基化敏感度(0.536)及特异性(0.609,P值均<0.05),差异有统计学意义。结论Ⅳ期胃癌患者腹腔脱落细胞DKK3基因甲基化率显著高于外周血,腹腔脱落细胞DKK3基因甲基化诊断胃癌腹膜种植转移的灵敏度及特异性均显著高于外周血。
Objective To study the clinical value of Dickkopf-3(DKK3)gene methylation in peritoneal exfoliated cells in the evaluation of disease condition and its prognosis for stageⅣgastric cancer.Methods DKK3 gene methylation in patients with stageⅣgastric cancer(gastric cancer group,n=120)and benign gastric disease group(control group,n=60)was detected and compared.The differences of DKK3 gene methylation in different clinicopathological features were analyzed.The differences in survival time with different DKK3 gene methylation in patients with stageⅣgastric cancer were compared with Kaplan-Meier method.The receiver operating characteristic(ROC)curve comparison of sensitivity and specificity of peritoneal exfoliated cells and blood DKK3 gene methylation in the diagnosis of peritoneal implant transfer were analyzed.Results The methylation rates of DKK3 gene methylation in peritoneal exfoliated cells(73.3%)and blood(60.0%)in the gastric cancer group were significantly higher than those in the control group(8.3%,χ2=70.303,all P<0.05).The DKK3 gene methylation in peritoneal exfoliated cells in the gastric cancer group had statistically significant differences in the degree of differentiation,maximum tumor diameter,and lymph node metastasis number(χ2=4.096,5.507,6.525,all P<0.05).The patients with DKK3 gene methylation had significantly shorter median survival time than patients with DKK3 gene unmethylation[(13.2±1.4)m vs.(16.4±1.7)m,Log-rank=7.817,P<0.01].The sensitivity(0.753)and specificity(0.811)of DKK3 gene methylation in peritoneal exfoliated cells in the diagnosis of peritoneal implant transfer were significantly higher than that of blood DKK3 gene methylation(0.536 and 0.609,all P<0.05).Conclusion The DKK3 gene methylation rate in peritoneal exfoliated cells is significantly higher than peripheral blood.The DKK3 gene methylation in peritoneal exfoliated cells has significantly higher sensitivity and specificity than peripheral blood.
作者
刘波
黄小梅
黄健
卢晓明
肖勇
Liu Bo;Huang Xiaomei;Huang Jian;Lu Xiaoming;Xiao Yong(Department of General Surgery,Suizhou Central Hospital,Hubei University of Medicine,Suizhou 441300,China;Department of Ultrasound Imaging,Suizhou Central Hospital,Hubei University of Medicine,Suizhou 441300,China;Department of Digestion Oncology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2020年第4期738-741,共4页
Chinese Journal of Experimental Surgery
