摘要
目的验证粪便硫酸类肝素蛋白多糖2(SDC2)基因甲基化检测在肠道肿瘤筛查中的诊断效能及应用价值。方法回顾性分析2021年11月至2023年12月于该院行粪便SDC2基因甲基化检测的1456例患者的临床资料,分析检测阳性率、肠镜依从性、灵敏度、特异度、阳性预测值及阴性预测值,并以病理诊断作为金标准,应用受试者工作特征(ROC)曲线及曲线下面积(AUC)判断诊断效果。结果1456例患者中粪便SDC2基因甲基化检测结果阳性者90例,阳性率为6.2%。不同性别检测阳性率比较,差异无统计学意义(P>0.05)。≥50岁阳性率高于<50岁,差异有统计学意义(P<0.05)。90例检测结果阳性者中67例完成肠镜检查,肠镜依从率为74.4%。不同性别、年龄肠镜依从率比较,差异无统计学意义(P>0.05)。67例完成肠镜检查者中发现结直肠癌6例(9.0%)、进展期腺瘤17例(25.4%)、非进展期腺瘤15例(22.4%)及非腺瘤性息肉6例(9.0%),病变检出率为65.7%。112例粪便SDC2基因甲基化检测阴性者中发现进展期腺瘤2例(1.8%)、非进展期腺瘤22例(19.6%)。该检测对结直肠癌及进展期腺瘤诊断的灵敏度和特异度分别为92.0%及71.4%,对结直肠肿瘤具有明显诊断意义(AUC为0.721,P<0.001)。结论粪便SDC2基因甲基化检测对结直肠癌初筛具有重要临床价值。
Objective To verify the diagnostic efficiency and application value of fecal syndecan 2(SDC2)gene methylation detection in intestinal tumor screening.Methods The clinical data of 1456 patients with fecal SDC2 gene methylation detection in this hospital from November 2021 to December 2023 were analyze retrospectively.The detection positive rate,colonoscopic compliance,sensitivity,specificity,positive predictive rate and negative predictive rate were analyzed.The pathological diagnosis served as the gold standard.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)were used to judge the diagnostic effect.Results In the results in 1456 cases of fecal SDC2 gene methylation detection,90 cases were positive with a positive rate of 6.2%.The positive rate had no statistical difference between different sexes(P>0.05).The positive rate in the patients≥50 years old was higher than that in the patients<50 year old(P<0.05).Among 90 cases of detection results positive,67 cases completed the enteroscopic examination and the enteroscopic compliance rate was 74.4%.The enteroscopic compliance rate had no statistical difference between the different sexes and among different ages of patients(P>0.05).Among 67 cases of enteroscopic examination completion,there were 6 cases(9.0%)of colorectal cancer,17 cases(25.4%)of progressive stage adenoma,15 cases(22.4%)of non-progressive stage adenoma,6 cases(9.0%)of non-adenomatous polyp and the lesion detection rate was 65.7%.Among 112 cases of fecal SDC2 gene methylation detection negative,there were 2 cases(1.8%)of progressive stage adenoma and 22 cases(19.6%)of non-progressive stage adenoma.The sensitivity and specificity of this detection for colorectal cancer and progressive stage adenoma were 92.0%and 71.4%,respectively,which had obvious diagnostic significance for colorectal tumor(AUC=0.721,P<0.001).Conclusion The fecal SDC2 gene methylation detection has an important clinical value in the preliminary screening of colorectal cancer.
作者
郭丽霞
张志勤
龚敏
徐芳华
GUO Lixia;ZHANG Zhiqin;GONG Min;XU Fanghua(Department of Pathology,Pingxiang Municipal People’s Hospital,Pingxiang,Jiangxi 337000,China;Department of Gastroenterology,Pingxiang Municipal People’s Hospital,Pingxiang,Jiangxi 337000,China)
出处
《重庆医学》
CAS
2024年第20期3095-3099,共5页
Chongqing Medical Journal
基金
江西省萍乡市科技计划项目(2022PY029)。
