外周血p73基因联合CEA检测在结直肠癌早期筛查中的意义

龙海华　贾安平　尹琦　庞丽萍　刘振鹏

【摘要】 目的：探討外周血p73基因甲基化联合CEA检测在结直肠癌早期筛查中的临床意义。方法：选取2013年6月-2017年3月本院住院患者142例，将其分为结直肠癌组64例和结直肠瘤组78例，另选取健康体检者142例为健康对照组。采用甲基化特异性PCR（MSP）对所有受检者行血浆p73基因甲基化检测，并测定血清CEA。比较单独与联合检测联合血浆p73基因甲基化及血清CEA对结直肠癌的诊断准确性、阴性预测值、敏感性及特异性。结果：结直肠癌组血浆p73基因甲基化、血清CEA和联合检测的阳性率均明显高于结直肠瘤组和健康对照组，差异均有统计学意义（P<0.001）；且结直肠瘤组均明显高于健康对照组，差异均有统计学意义（P<0.001）。联合血浆p73基因甲基化测定和血清CEA对结直肠癌的诊断敏感性优于单独检测（ 字2=9.581、16.762，P<0.01）；阴性预测值高于单独检测，特异性低于单独检测，但差异均无统计学意义（P>0.05）。结论：联合血浆p73基因甲基化测定及血清CEA对结直肠癌的早期筛查有重要的临床意义。

【关键词】 p73基因； 甲基化； 结直肠癌； 联合检测

Diagnostic Value of Peripheral Blood p73 Gene Methylation Combined with CEA in Early Screening of Colorectal Cancer/LONG Hai-hua，JIA An-ping，YIN Qi，et al.//Medical Innovation of China，2017，14（27）：119-122

【Abstract】 Objective：To explore the diagnostic value of peripheral blood p73 gene methylation combined with CEA in early screening of colorectal cancer.Method：142 cases of hospitalized from June 2013 to March 2017 were selected，they were divided into colorectal cancer group（64 cases） and colorectal tumor group（78 cases），another 142 healthy subjects were selected as healthy control group.The methylation specific PCR（MSP） was used to detect plasma p73 gene methylation in all subjects，and the serum CEA was determined.The diagnostic accuracy，negative predictive value，sensitivity and specificity of the single and combined plasma p73 gene methylation positive rate and serum CEA of colorectal cancer were compared.Result：The positive rate of p73 gene methylation，serum CEA and joint detection in colorectal cancer group were significantly higher than those in colorectal tumor group and healthy control group，the differences were statistically significant （P<0.001）；and the colorectal tumor group was significantly higher than the healthy control group，the difference was statistically significant（P<0.001）.Joint p73 gene methylation determination of plasma and serum CEA was superior to the single detection for diagnosis of colorectal cancer susceptibility（ 字2=9.581，16.762，P<0.01）；the negative predictive value was higher than that of the individual，and the specificity was lower than that of the individual，but the differences were not statistically significant（P>0.05）.Conclusion：Plasma p73 gene methylation measurement combined with of serum CEA has important clinical significance for early screening of colorectal cancer.

【Key words】 p73 gene； Methylation； Colorectal cancer； Combination of detecting

First-authors address：Liutie Central Hospital of Liuzhou City，Liuzhou 545007，Chinaendprint

doi：10.3969/j.issn.1674-4985.2017.27.034

结直肠癌（Colorectal cancer，CRC）是消化道常见的恶性肿瘤，2015年我国CRC发病率呈明显上升趋势[1-2]，早期诊断CRC的患者5年生存率可达90%[3]。p73基因启动子甲基化的异常与肿瘤的发生、发展密切相关[4-7]，而CEA是消化道肿瘤的重要肿瘤标准物[8-11]。本研究对外周血p73基因甲基化状态及血清CEA进行检测，观察联合两种检测对CRC早期筛查的临床意义，现报道如下。

1 资料与方法

1.1 一般资料 选取2013年6月-2017年3月本院住院患者142例，患者均无明确恶性肿瘤疾病史，未接受放疗、化疗及免疫抑制等治疗。以组织病理学为依据，将其分为结直肠癌组64例，男36例，女

28例，年龄31～85岁，中位年龄52岁；结直肠瘤组78例，男43例，女35例，年龄27～88岁，中位年龄47岁；另选取健康体检者142例为健康对照组，男67例，女75例，年龄25～89岁，中位年龄42岁。……