Circulating Methylated Septin 9 Nucleic Acid in the Plasma of Patients with Gastrointestinal Cancer in the Stomach and Colon
Circulating Methylated Septin 9 Nucleic Acid in the Plasma of Patients with Gastrointestinal Cancer in the Stomach and Colon
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DOI：
10.1593/tlo.13118
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发表时间：
2013-06-01
影响因子：
5
通讯作者：
Park, Kyoung Un
中科院分区：
文献类型：
--
作者：
Lee, Hye Seung;Hwang, Sang Mee;Park, Kyoung Un
背景技术背景：血浆中的甲基化Septin 9（mSEPT 9）最近被建议作为具有可变灵敏度的结直肠癌（CRC）的筛选标志物。我们的目的是确定血浆mSEPT 9筛查CRC和胃癌（GC）的有用性及其在术后CRC患者中的诊断作用。方法：收集101例结直肠癌患者、153例胃癌患者和96例健康人的350份外周血标本。此外，我们从27例根治性手术后的CRC患者中获得了35份随访血液样本。检测血浆mSEPT 9、血清癌胚抗原（CEA）和血清CA 19 -9水平，并结合临床病理特征进行分析。结果：血浆mSEPT 9检测结直肠癌和胃癌的敏感性分别为36.6%和17.7%，特异性为90.6%。在随访期间，9例CRC患者中有8例（88.9%）的mSEPT 9显示阴性转换，这些患者在根治性手术前血浆mSEPT 9呈阳性。在结直肠癌和胃癌中，血浆mSEPT 9水平升高的患者有发生远处转移和无病生存率降低的趋势。在胃癌患者中，肠型（23.5%）和混合型（40.0%）的mSEPT 9阳性率高于弥漫型（7.3%; P = . 009）。mSEPT 9、CEA和CA 19 -9的联合分析将诊断GC的敏感性提高至32.7%（P = .002）。结论：考虑到血浆mSEPT 9在肠道或混合型GC中的高发生率与CRC相似，应通过血浆mSEPT 9筛查试验检查GC。此外，血浆mSEPT 9被提议作为CRC患者的随访标志物，但需要进一步验证。
BACKGROUND: Methylated Septin 9 (mSEPT9) in plasma has recently been suggested as a screening marker for colorectal cancer (CRC) with variable sensitivity. We aimed to determine the usefulness of plasma mSEPT9 for screening CRC and gastric cancer (GC) and its diagnostic role in postoperative CRC patients. METHODS: A total of 350 peripheral blood samples from 101 CRC patients, 153 GC patients, and 96 healthy persons were collected. In addition, we obtained 35 follow-up blood samples from 27 CRC patients after curative radical surgery. Plasma mSEPT9, serum carcinoembryonic antigen (CEA), and serum CA19-9 were evaluated with clinicopathologic features. RESULTS: The sensitivity of plasma mSEPT9 was 36.6% for detecting CRC and 17.7% for detecting GC, and the specificity was 90.6%. During follow-up periods, mSEPT9 showed negative conversion in eight of nine CRC patients (88.9%) whose plasma mSEPT9 had been positive before radical surgery. The patients with plasma mSEPT9 had a tendency of presence of distant metastasis and lower disease-free survival in both CRC and GC. In GC patients, plasma mSEPT9 was more frequently observed in intestinal (23.5%) and mixed type (40.0%) than diffuse type (7.3%; P = . 009). Combined analysis of mSEPT9, CEA, and CA19-9 increased the sensitivity for diagnosing GC to 32.7% (P = .002). CONCLUSION: Considering the high incidence of plasma mSEPT9 in intestinal or mixed type GCs similar to CRCs, GC should be examined through the plasma mSEPT9 screening test. In addition, plasma mSEPT9 is proposed as a follow-up marker in CRC patients, but further validation is required.