2021 年第 6 期 第 16 卷

胰岛素样生长因子结合蛋白相关蛋白1基因甲基化检测联合粪便潜血定量试验在结直肠癌中的诊断价值 

Diagnostic value of insulin-like growth factor binding protein-related protein 1 gene methylation detection combined with fecal occult blood quantitative test in colorectal cancer

作者：高文仓1张月蒙2

英文作者：Gao Wencang1 Zhang Yuemeng2

单位：1浙江中医药大学附属第二医院肿瘤科，杭州310005；2山东省曹县人民医院外科，山东省菏泽市274400

英文单位：1Department of Oncology the Second Affiliated Hospital of Zhejiang Chinese Medical University Hangzhou 310005 China; 2Department of Surgery Caoxian People′s Hospital Shandong Province Heze 274400 China

关键词：结直肠癌；胰岛素样生长因子结合蛋白相关蛋白1；粪便潜血定量试验

英文关键词：Colorectalcancer;Insulin-likegrowthfactorbindingprotein-relatedprotein1;Fecaloccultbloodquantitativetest

• 摘要：

• 目的 探讨胰岛素样生长因子结合蛋白相关蛋白1（IGFBP-rP1）基因甲基化检测联合粪便潜血定量试验对结直肠癌的诊断价值。方法 选取2017年1月至2020年12月浙江中医药大学附属第二医院住院治疗的92例结直肠癌患者（结直肠癌组），另选取同期于本院体检的50例健康志愿者（对照组）。比较2组IGFBP-rP1基因甲基化状态，以及不同性别、年龄、肿瘤位置、分化程度受试者IGFBP-rP1基因甲基化状态。比较2组粪便潜血定量水平。分析IGFBP-rP1基因甲基化状态和粪便潜血定量水平对结直肠癌的诊断价值。结果 结直肠癌组IGFBP-rP1基因甲基化比例明显低于对照组［50.0%（46/92）比84.0%（42/50）］，差异有统计学意义（P＜0.001）。不同性别、年龄、肿瘤部位、分化程度的受试者IGFBP-rP1基因甲基化比例比较，差异均无统计学意义（均P＞0.05）。结直肠癌组粪便潜血定量水平明显高于对照组［（2 377±903）μg/L比（1 496±254）μg/L］，差异有统计学意义（P＜0.001）。二元Logistic回归分析结果显示，IGFBP-rP1基因甲基化是结直肠癌发生的独立保护因素，粪便潜血定量水平升高是独立危险因素（均P＜0.05）。受试者工作特征曲线分析结果显示，IGFBP-rP1基因甲基化状态和粪便潜血定量水平预测结直肠癌发生的曲线下面积（AUC）分别为0.791（95%置信区间：0.705~0.877）、0.769（95%置信区间：0.691~0.847），二者联合检测的AUC为0.903（95%置信区间：0.855~0.952），高于单独检测。结论 IGFBP-rP1基因甲基化是结直肠癌发生的独立保护因素，粪便潜血定量水平升高是独立危险因素，二者联合检测可提高对结直肠癌的早期诊断价值。

• Objective To explore the diagnostic value of insulin-like growth factor binding protein-related protein 1(IGFBP-rP1) gene methylation detection combined with fecal occult blood quantitative test in colorectal cancer. Methods From January 2017 to December 2020, 92 patients with colorectal cancer admitted to the Second Affiliated Hospital of Zhejiang Chinese Medical University were enrolled(colorectal cancer group). Other 50 healthy volunteer undergoing physical examination at the same period in the hospital were enrolled(control group). The methylation status of the IGFBP-rP1 gene was compared between the two groups, and was compared between different gender, age, tumor location and tumor differentiation in subjects. The fecal occult blood quantitative level was compared between the two groups. The predictive value of methylation status of the IGFBP-rP1 gene and fecal occult blood quantitative level for colorectal cancer was analyzed. Results The rate of IGFBP-rP1 gene methylation in colorectal cancer group was significantly lower than that in control group［50.0%(46/92) vs 84.0%(42/50)］(P<0.001). There were no significant differences in rates of IGFBP-rP1 gene methylation between different gender, age, tumor location and tumor differentiation in subjects(all P>0.05). The fecal occult blood quantitative level in colorectal cancer group was significantly higher than that in control group［（2 377±903）μg/L vs （1 496±254）μg/L］(P<0.001). Binary Logistic regression analysis indicated that IGFBP-rP1 gene methylation was an independent protective factor for the occurrence of colorectal cancer and the increase in fecal occult blood quantitative level was an independent risk factor (both P<0.05). The receiver operating characteristic curve analysis indicated that the area under the curve(AUC) of IGFBP-rP1 gene methylation and fecal occult blood quantitative level in predicting occurrence of colorectal cancer was 0.791［95% confidence interval(CI): 0.705-0.877］ and 0.769(95% CI: 0.691-0.847), respectively. The AUC of the two indicators combined was 0.903(95% CI: 0.855-0.952), and it was higher than those single detection. Conclusions  The methylation of IGFBP-rP1 gene is an independent protective factor for the occurrence of colorectal cancer and the increase in the fecal occult blood quantitative level is an independent risk factor. Combining the above two detection methods  can improve the early diagnostic value for colorectal cancer.