摘要
目的通过检测老年结直肠癌(colorectal cancer,CRC)患者粪便DNA中人类错配修复基因1(human mutl homolog 1,hMLH1)甲基化水平,探讨其临床价值,为老年CRC患者的早期无创诊断探索新途径。方法选取作者医院自2015-06/2016-09月确诊的30例年龄在60岁以上的CRC患者为观察组,选择同期的30例60岁以上且体检正常者为对照组。分别提取两组患者的粪便DNA,采用甲基化特异性聚合酶链反应(methylation specific polymerase chain reaction,MSP)技术检测其hMLH1基因的甲基化状态;同时,收集观察组患者的外周血,检测血清中的癌胚抗原(carcinoembryonic antigen,CEA);分别比较观察组患者hMLH1基因甲基化检出率与CEA检出率,以及观察组与对照组甲基化检出率的差异性;分析观察组患者hMLH1基因甲基化与患者年龄、性别、肿瘤位置的相关性。结果观察组患者hMLH1基因甲基化检出率为63.33%(19/30)显著高于对照组的6.67%(2/30)(χ~2=21.172,P<0.01);观察组患者MSP法甲基化检出率63.33%显著高于传统CEA检测法的检出率36.67%(11/30)(χ~2=4.67,P<0.05);CRC患者hMLH1基因甲基化与患者年龄、性别、肿瘤位置均无显著相关性(P>0.05)。结论观察组患者粪便DNA中hMLH1基因甲基化检出率较高,明显优于传统的血清CEA检测,可作为早期无创诊断老年性CRC的重要手段。
Objective To investigate the clinical value of the methylation level of human mutl homolog 1（hMLH1）in stool DNA of senile colorectal cancer（CRC）,and explore its new method for early noninvasive diagnosis of CRC.Methods A total of 30 CRC patients from authors＇ hospital who were aged over 60 years from June 2015 to September 2016 were selected for the observation group.At the same time,30 individuals who passed the physical examination and aged over 60 years were selected as the control group.Stool DNA of patients from two groups was extracted respectively,and the methylation status of hMLH1 gene was detected by methylation specific polymerase chain reaction（MSP）.Meanwhile,the peripheral blood of CRC patients in observation group was collected and the carcinoembryonic antigen（CEA）in serum was detected.The detection rate of hMLH1 gene methylation and detection rate of CEA in observation group were compared respectively,and the differences of detection rate of methylation between two groups were compared.And the correlation between methylation of hMLH1 gene and age,sex and tumor location of CRC patients in observation group was analyzed.Results The detection rate of hMLH1 gene methylation was 63.33%（19/30）in CRC patients in observation group,which was significantly higher than that in control group（χ~2=21.172,P0.01）and the detection rate of MSP methylation（63.33%）was significantly higher than that of the traditional CEA detection method（36.67%,11/30）（χ~2=4.67,P0.05）.And there was no significant correlation between hMLH1 gene methylation and age,sex and tumor location of CRC patients in observation group（P0.05）.Conclusion The detection rate of methylation of hMLH1 gene in stool DNA of CRC patients in observation group is significantly higher than that of traditional detection of CEA in peripheral blood serum.It can be used as a crucial means for early noninvasive diagnosis and screening of senile CRC.
出处
《华南国防医学杂志》
CAS
2017年第12期814-817,共4页
Military Medical Journal of South China
