Sept9基因甲基化在直结肠癌早期诊断中应用的临床意义介绍.docVIP

SEPT9基因甲基化在直结肠癌早期诊断中应用的临床意义 [摘要]目的：集中探讨sept9基因甲基化对于临床上直结肠癌的早期诊断应用中的临床意义。方法：随机选取2015年3月-2015年12月因患结直肠癌于我院普外科进行手术治疗的患者100例，从术中选取的癌灶、其癌旁组织和术前粪便样本中提取DNA，应用多重置换扩增（MDA）结合巢式甲基化特异性PCR扩增技术（nMPS）检测患者术前粪便样本中SEPT基因的甲基化水平，同时比较粪便同癌灶组织中SEPT9基因甲基化在诊断结直肠癌中的敏感度及其特异度。结果：针对100例患者的癌灶组织的SEPT9基因的分析中，其中基因甲基化的发生率为84.0%；在针对癌旁组织的SEPT9基因的分析中，其中基因甲基化的发生率8.0%。在患者癌灶及癌旁组织SEPT9基因甲基化发生率的比较中，二者差异较大，具有明显的统计学意义（P 0.01）；临床分期为Ⅰ、Ⅱ期的结直肠癌患者，采用SEPT基因甲基化诊断的准确率为87.5%；临床分期为Ⅲ、Ⅳ期的结直肠癌患者，采用SEPT基因甲基化诊断的准确率为80.0%。针对不同的临床分期，采用SEPT基因甲基化诊断结直肠癌的准确率差异不大，不具有统计学意义（P 0.05）。结论：因粪便中SEPT9基因甲基化检测在结直肠癌患者中的特异度和敏感度较高，可在临床中应用于早期诊断。 [关键词]SEPT9基因；直结肠癌；早期诊断 Study of early diagnosis of colorectal cancer by analysis of stool SEPT9 gene methylation 【Abstract】Objective To investigate the diagnosis of colorectal cancer by analysis of SEPT9 methylation in stool DNA. Methods The stool SEPT9 gene methylation were detected by multiple displacement amplification/ nested methylation specific PCR,MDA-nMSP in 100 colorectal cancer tissues,para-cancer tissues and stool DNA. The sensitivity and specificity of SEPT9 methylation marker in colorectal cancer diagnosis were analyzed. Results Among 100 colorectal cancers,SEPT9 gene methylation was found in 84. 0% of cancer tissues and 8.0% of para-cancer tissues respectively. The sensitivity and specificity of SEPT9 for diagnosis of colorectal cancer were 84. 0% and 92. 0% respectively,and the stool SEPT9 had similar sensitivity as cancer tissues in diagnosis of colorectal cancer. There were no any differences for incidence of SEPT9 methylation among different clinical stages. Conclusions The abnormal methylation of SEPT9 happen frequently in colorectal cancer; hypermethylaion of SEPT9 gene mehylation in stool DNA can be used as a candidate of tumor marker for early diagnosis of colorectal cancer. 【Key words】Septin9 gene; Colorectal neoplasms; Early diagnosis 相关临床数据表明，近年来我国患有直结肠癌的患者比例逐年攀升，好发率占据各肿瘤疾病发生的前5位。目前临床上针对早期发现的直结肠癌患者主要采用手术治疗的方式，并且疗效较好[1-2]。对于直结肠癌晚期的患者在采用化疗联合分子靶向治疗后临床效果依然不佳[3]。因此临床上能否对于直结肠癌患者进行早期诊