摘要
目的探究血浆Septin9基因甲基化与血清癌胚抗原(CEA)检测在腹腔镜结直肠癌(CRC)术后随访中的监测价值。方法选择98例CRC择期开展腹腔镜手术治疗患者为观察组;选择健康体检者98例为对照组。比较两组血浆Septin9基因甲基化阳性率和CEA阳性率。以再次手术后病理检查、内窥镜、多种影像学检查结合血清学综合判断及临床随访为金标准,评价血浆Septin 9基因甲基化在CRC术后随访中的监测价值。结果观察组血浆Septin9基因甲基化阳性率、血清CEA阳性率明显高于对照组,差异均有统计学意义(χ^2分别=118.89、50.65,P均<0.05);术后随访2~6个月,平均(4.51±0.50)个月,最终确诊术后转移/复发38例。血浆Septin9基因甲基化监测准确率86.73%,灵敏度73.68%,特异度95.00%,阳性预测值90.32%,阴性预测值85.07%,高于血清CEA监测准确率62.24%,灵敏度34.21%,特异度80.00%,阳性预测值52.00%,阴性预测值65.75%,差异均有统计学意义(χ^2分别=15.47、11.92、6.17、10.36、6.96,P均<0.05)。结论与血清CEA比较,血浆Septin9基因甲基化具有较高监测准确率、灵敏度、特异度、阳性预测值、阴性预测值,可考虑作为CRC腹腔镜术后随访分子标志物。
Objective To explore the monitoring value of Septin9 gene methylation in plasma and carcinoembryonic antigen(CEA)in postoperative follow-up of laparoscopic surgery of colorectal cancer(CRC).Methods Totally 98 CRC patients undergoing elective laparoscopic surgery were selected as the observation group,98 healthy subjects were selected as control group.The positive rates of Septin9 methylation in plasma and CEA were compared between the two groups.The monitoring value of Septin9 gene methylation in plasma and CEA in laparoscopic surgery of CRC was evaluated.Results The positive rate of Septin9 gene methylation and CEA of the observation group was significantly higher than those of control group(χ^2=118.89,50.65,P<0.05).The patients were followed up for 2 to 6 months,with an average of(4.51±0.50)months,and 38 cases of postoperative metastasis or recurrence were finally confirmed.The accuracy,sensitivity,specificity,positive predictive value,and negative predictive value of Septin9 gene methylation in plasma were 86.73%,73.68%,95.00%,90.32%,and 85.07%,which were higher than those of serum CEA,the difference was statistically significant(χ^2=15.47,11.92,6.17,10.36,6.96,P<0.05).Conclusion Comparing with serum CEA,plasma Septin9 methylation has higher monitoring accuracy,sensitivity,specificity,positive predictive value and negative predictive value,and can be using as a molecular marker for follow-up after CRC laparoscopic surgery.
作者
黄剑辉
吴敏华
楼建
刘雪妮
谢艳茹
HUANG Jianhui;WU Minhua;LOU Jian(Department of Oncology,Lishui Municipal Central Hospital,Lishui 323000,China)
出处
《全科医学临床与教育》
2020年第11期973-975,共3页
Clinical Education of General Practice
基金
浙江省医学会临床科研资金项目(2017ZYCA128)。
