胡启华 1欧爱芝 1王蓉 2林迪莎 1李红 1叶新萍1
作者信息
- 1. 湖南中医药大学第一附属医院,湖南长沙 410007
- 2. 湖南中医药大学,湖南长沙 410208
- 折叠
摘要
Abstract
Objective To evaluate the feasibility of a blood-based test targeting circulating tumor DNA methylation for colorectal cancer(CRC)and colorectal disease screening in the health check-up population,and to explore the value of this multilocus methylation test as a screening method in different risk groups.Methods Blood samples from 447 physical examination subjects were collected and underwent multilocus methylation test in this study.Subjects with positive results were recommended to take colonoscopy and then the positive rate,the lesion detection rate,sensitivity,and positive predictive value(PPV)of the test were ana-lyzed.Then the patients were divided into the high-risk group[≥50 years old,male,with adverse indicators(at least met two of the four factors:hyperlipidemia,smoking history,drinking history,and BMI≥24 kg/m2)]and the control group,to explore the screening effect of the test in different risk populations.Results A total of 447 subjects were enrolled in this study.In 35 cases with positive test results,there were 28 cases received colonoscopy with a compliance rate of 80%(28/35).The abnormal colonoscopy(CRC,adenoma,polyp,and inflammation)detection rate was 89.3%(25/28)and the CRC or adenoma detection rate was 28.6%(8/28).The sensitivity and PPV for abnormal colonoscopy results was 89.3%and 89.3%respectively,and the sensi-tivity and PPV for CRC and adenoma patients was 100%and 28.6%respectively.The positive rate of the test in the high-risk group and the control group had a significant difference(15.3%vs.6.1%,P=0.004),and the abnormal detection rate between the two groups had a significant difference too(12.9%vs.3.9%,P=0.003).In the high-risk group,the sensitivity and PPV for abnormal colonoscopy results was 100%and 91.7%respec-tively,while in the control group was 82.4%and 87.5%.For CRC and adenoma screening,the sensitivity and PPV of the test in the high-risk group was 100%and 25%respectively,and in the control group was 100%and 31.2%respectively.The test was more sensitive than carcinoembryonic antigen(CEA)for abnor-mal colonoscopy results(89.3%vs.29.6%).Conclusion The multilocus blood-based test targeting circu-lating tumor DNA methylation detection can effectively screen intestinal malignant tumors and other lesions,and it has a better effect when applied to the screening colorectal cancer in high-risk populations.关键词
结直肠肿瘤/高危人群/多基因甲基化检测/筛查Key words
colorectal neoplasms/high risk population/multigene methylation detection/screening
