论文部分内容阅读
目的探讨p73基因甲基化和癌胚抗原(carcinoembryonic antigen,CEA)检测在结直肠癌诊断中的临床意义。方法受检者分为三组,即结直肠癌组(A组)64例,结直肠瘤组(B组)78例,健康对照组(C组)142例。另将A、B组患者病灶组织以外5 cm以上,病理组织学诊断为正常粘膜组织的97例标本纳入组织对照组(D组)。采用甲基化特异性PCR(methylation specific PCR,MSP)行组织、血浆p73基因甲基化测定,并检测血清CEA,比较单独和联合检测对结直肠癌诊断的敏感性和特异性,以及联合检测对结直肠癌诊断接受者的工作特征曲线(receiver operatingcharacteristics,ROC)分析。结果组织与血浆p73基因甲基化阳性率的差异在A、B两组中均无统计学意义(P>0.05);三种检测方法的阳性率在对照组-瘤-癌序列中均逐渐升高(P<0.01);联合三种检测方法对结直肠癌诊断的灵敏性高于两两方法的联合检测(P<0.05),但特异性的下降无统计学意义(P>0.05);联合三种检测方法诊断结直肠癌的ROC曲线下面积(area under the curve,AUC)为0.896,高于三种检测方法中任意两两联合的AUC(0.828,0.837,0.850)。结论联合组织、血浆p73基因甲基化测定及血清CEA对结直肠癌的诊断有重要的临床意义。
Objective To investigate the clinical significance of p73 gene methylation and carcinoembryonic antigen (CEA) detection in the diagnosis of colorectal cancer. Methods The subjects were divided into three groups: 64 cases in colorectal cancer group (A group), 78 cases in colorectal tumor group (B group) and 142 cases in healthy control group (C group). Another group of A, B patients with lesions more than 5 cm, histopathological diagnosis of normal mucosa in 97 cases of specimens into the control group (D group). Methylation-specific PCR (MSP) was used to detect the tissue and plasma p73 gene methylation, and the serum CEA was detected. The sensitivity and specificity of single and combined detection for the diagnosis of colorectal cancer were compared, and the combined detection Receiver operating characteristics (ROC) analysis of recipients with colorectal cancer diagnoses. Results The positive rate of methylation of p73 gene between plasma and tissue was not significantly different between A and B groups (P> 0.05). The positive rates of three detection methods were gradually increased in control group and tumor-cancer sequence (P <0.01). The combined detection of the three methods was more sensitive to the diagnosis of colorectal cancer than the combined detection of two methods (P <0.05), but the specific decrease was not statistically significant (P> 0.05) The area under the curve (AUC) of three detection methods for diagnosing colorectal cancer was 0.896, which was higher than the AUC (0.828, 0.837, 0.850) of any two of the three detection methods. Conclusion The detection of methylation of plasma p73 gene and serum CEA have important clinical significance in the diagnosis of colorectal cancer.