朱云峰,陈晓飞.粪便隐血试验与SDC2基因甲基化检测在结直肠癌筛查中的效果评价[J].中国肿瘤,2022,31(9):723-727.
粪便隐血试验与SDC2基因甲基化检测在结直肠癌筛查中的效果评价
Evaluation of Immunochemical Fecal Occult Blood Test and SDC2 Gene Methylation Test in Colorectal Cancer Screening
投稿时间:2022-05-10  
DOI:10.11735/j.issn.1004-0242.2022.09.A007
中文关键词:  结直肠癌  筛查  粪便隐血试验  SDC2基因甲基化  效果评价
英文关键词:colorectal cancer  screening  fecal immunochemical test  SDC2 gene methylation  effectiveness evaluation
基金项目:海宁市2021年科技计划社发项目(2021104)
作者单位
朱云峰 海宁市中医院海宁市肿瘤防治研究所 
陈晓飞 海宁市中医院海宁市肿瘤防治研究所 
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中文摘要:
      摘 要:[目的] 比较粪便SDC2基因甲基化检测与粪便隐血试验用于人群结直肠癌筛查效果,为今后开展结直肠癌筛查技术及方案优化提供科学依据。[方法] 以海宁市结直肠癌早诊早治筛查为平台,于2021年5月采用整群抽样方法抽取海宁市袁花镇3 000名40~74岁人群为研究对象,将SDC2基因甲基化检测纳入现有筛查路径,初筛包括结直肠癌风险评估、粪便隐血试验和SDC2基因甲基化检测,其中任一项阳性动员电子结肠镜检查,以结肠镜+病理结果为金标准判定筛查结果。[结果] 共有2 664名对象完成结直肠癌风险评估并按要求同时送检了两份大便样品,其中男性1 303名,女性1 361名。单项粪便SDC2基因甲基化阳性为232例(8.71%),阳性者中116例(50.00%)完成肠镜检查;单项粪便隐血试验阳性为243例(9.12%),阳性者中126例(51.85%)完成结肠镜检查;粪便隐血试验和SDC2基因甲基化检测双阳性51例(Kappa=0.077,P=0.614),双阳性者中28例(54.90%)完成结肠镜检查,三组差异无统计学意义(χ2=0.452, P=0.798)。在单阳性组中,粪便隐血检测的肠道病变检出率50.79%(64/126),低于粪便SDC2基因甲基化检测的肠道病变检出率51.72%(60/116),其中粪便SDC2基因甲基化检测的进展期肿瘤检出率12.93%(15/116),高于粪便隐血试验的进展期肿瘤检出率(8.73%,11/116)(P<0.001)。在双阳性组中,粪便隐血试验联合粪便SDC2基因甲基化检测的肠道病变检出率53.57%(15/28),其中进展期肿瘤检出率25.00%(7/28),高于单阳性组,但差异无统计学意义(χ2=6.324, P=0.388)。[结论] 粪便SDC2基因甲基化检测对进展期肿瘤病变检出率高于粪便隐血试验,粪便隐血试验联合SDC2基因甲基化检测有助于提高肠道病变检出率。
英文摘要:
      Abstract:[Purpose]To compare the efficacy of stool SDC2 gene methylation test and immunochemical fecal occult blood test(FIT) in colorectal cancer screening. [Methods] Based on the Haining colorectal cancer screening program, 3 000 people aged 40-74 years in Yuanhua Town of Haining City were selected by cluster sampling. The screening procedures included colorectal cancer risk assessment, FIT and SDC2 gene methylation test. Colonoscopy and pathological results were used as the gold standard to evaluate the screening results. [Results] A total of 2 664 subjects(1 303 males and 1 361 females) completed the colorectal cancer risk assessment and submitted two stool samples as required. Among them, 232 cases(8.71%) were positive by the SDC2 gene methylation test, and 116 cases(50.00%) of them completed colonoscopy; 243 cases(9.12%) tested positive by FIT and 126 cases(51.85%) completed colonoscopy; 51 cases were double-positive by FIT and SDC2 gene methylation(Kappa=0.077, P=0.614), and 28 cases(54.90%) completed colonoscopy, there was no significant difference among the three groups(χ2=0.452, P=0.798). Among single-positive subjects, the detection rates of colorectal lesions by FIT and SDC2 gene methylation test were 50.79%(64/126) and 51.72%(60/116), respectively, and the detection rates of advanced neoplasms by fecal SDC2 gene methylation test and by FIT were 12.93%(15/116) and 8.73%(11/116), respectively(P<0.001). In the double-positive group, the detection rates of colorectal lesions and advanced neoplasms were 53.57%(15/28), and 25.00%(7/28), respectively; there was no significant difference with those of single detection(χ2=6.324, P=0.388). [Conclusion] The advanced neoplasms detection rate of SDC2 gene methylation in stool is higher than that of FIT. FIT combined with SDC2 gene methylation could improve the detection rate of colorectal lesions.
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