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[目的]探讨粪便DNA检测在大肠肿瘤机会性筛查中的价值。[方法]进入筛查的人群中连续收集46例大肠癌(CRC)、60例大肠腺瘤(CRA)及30例正常粪便标本,采用PCR-SSCP银染法检测粪便DNA突变情况,并与免疫法粪便隐血试验(IFOBT)比较。[结果]CRC组、CRA组和正常组IFOBT的阳性率分别为45.7%(21/46)、18.3%(11/60)和13.33%(4/30);CRC组、CRA组和正常组APC的突变率分别为58.7%(27/46)、20.0%(12/60)和3.33%(1/30),p53的突变率分别为65.2%(30/46)、25.0%(15/60)和0%(0/30),K-ras的突变率分别为60.9%(28/46)、23.3%(14/60)和0%(0/30),粪便DNA 3个基因联合检测的突变率分别为76.1%(35/46)、35.0%(21/60)和3.33%(1/30)。CRC组、CRA组中APC、p53、K-ras基因单独检测的敏感性与IFOBT比较,差异均无统计学意义(P>0.05);CRC组、CRA组粪便DNA 3个基因联合检测的敏感性均高于IFOBT,差异有统计学意义(P<0.05);CRC组、CRA组粪便DNA 3个基因单独和联合检测大肠肿瘤的特异性均高于IFOBT,但均差异无统计学意义(P>0.05)。[结论]粪便DNA联合检测大肠肿瘤的敏感性高于IFOBT,提示粪便DNA检测可能是更适于机会性筛查大肠肿瘤的无创性筛查方法。
[Objective] To investigate the value of stool DNA detection in opportunistic screening of colorectal tumors. [Methods] 46 cases of colorectal cancer (CRC), 60 cases of colorectal adenoma (CRA) and 30 normal stool specimens were collected continuously from the screening population. The stool DNA mutation was detected by PCR-SSCP silver staining and was compared with the immunization Law fecal occult blood test (IFOBT) comparison. [Results] The positive rates of IFOBT in CRC group, CRA group and normal group were 45.7% (21/46), 18.3% (11/60) and 13.33% (4/30), respectively. CRC, CRA and normal group APC The mutation rates of p53 were 65.2% (30/46) and 25.0% (15/60), respectively. The mutation rates of p53 were 58.7% (27/46), 20.0% (12/60) and 3.33% And 0% (0/30) respectively. Mutations of K-ras were detected in 60.9% (28/46), 23.3% (14/60) and 0% (0/30) Rates were 76.1% (35/46), 35.0% (21/60) and 3.33% (1/30), respectively. There were no significant differences in the sensitivity of APC, p53 and K-ras genes between CRC group and CRA group when compared with IFOBT alone (P> 0.05). The sensitivity of combined detection of 3 genes in CRC group and CRA group (P <0.05). The specificities of three genes in stool DNA of CRC group and CRA group were higher than that of IFOBT alone or in combination with IFOBT (P <0.05), but there was no significant difference (P> 0.05). [Conclusion] The combined detection of stool DNA and colorectal cancer is more sensitive than that of IFOBT, suggesting that stool DNA testing may be a more noninvasive screening method for opportunistic screening of colorectal tumors.