CAJ | 학술논문

背景与目的：结直肠癌(colorectal cancer，CRC)是全球发病率第三，死亡率第四的恶性肿瘤。遗传学及表观遗传学的改变引发抑癌基因甲基化表达沉默是CRC发生的重要原因，本研究旨在探讨血浆、粪便GATA5启动子甲基化检测在CRC临床诊断中的应用价值。方法：收集34例健康体检者和43例CRC患者的血浆和配对的粪便标本。采用甲基化特异性PCR法(methylation specific PCR method，MSP)检测其血浆、粪便中GATA5甲基化水平，并分析其与临床病理特征相关性。结果：MSP结果显示CRC患者血浆、粪便中GATA5启动子甲基化率(60.74%、76.60%)高于健康者发生率(26.47%、32.35%)，差异均有统计学意义(P值分别为0.0067，0.0002)。CRC患者血浆甲基化发生率与临床分期(P=0.0005)、淋巴结转移(P=0.020)密切相关，而粪便GATA5甲基化水平与临床病理特征无统计学意义。结论：检测粪便GATA5甲基化水平并辅以血浆GATA5甲基化水平可作为一种简单、非侵入、敏感及特异的方法应用于CRC患者的临床诊断。
배경여목적：결직장암(colorectal cancer，CRC)시전구발병솔제삼，사망솔제사적악성종류。유전학급표관유전학적개변인발억암기인갑기화표체침묵시CRC발생적중요원인，본연구지재탐토혈장、분편GATA5계동자갑기화검측재CRC림상진단중적응용개치。방법：수집34례건강체검자화43례CRC환자적혈장화배대적분편표본。채용갑기화특이성PCR법(methylation specific PCR method，MSP)검측기혈장、분편중GATA5갑기화수평，병분석기여림상병리특정상관성。결과：MSP결과현시CRC환자혈장、분편중GATA5계동자갑기화솔(60.74%、76.60%)고우건강자발생솔(26.47%、32.35%)，차이균유통계학의의(P치분별위0.0067，0.0002)。CRC환자혈장갑기화발생솔여림상분기(P=0.0005)、림파결전이(P=0.020)밀절상관，이분편GATA5갑기화수평여림상병리특정무통계학의의。결론：검측분편GATA5갑기화수평병보이혈장GATA5갑기화수평가작위일충간단、비침입、민감급특이적방법응용우CRC환자적림상진단。
Background and purpose:Colorectal cancer (CRC) is a malignancy which is the third incidence and the fourth mortality in the worldwide. The main reason for the development of CRC is that the changes of genetic and epigenetic causes the tumor suppressor gene methylation silencing. This study aimed to investigate the plasma and stool GATA5 gene promoter methylation was detected in clinical diagnosis of CRC. Methods: To collect the paired plasma and stool specimens of 34 cases of healthy and 43 cases of patients with CRC. Methylation speciifc PCR (MSP) was respectively detected the GATA5 gene methylation levels of GATA5 gene in plasma and stool. And then separately analyzed their correlations with clinical and pathological parameters in gastric carcinoma. Results: The result of MSP showed that GATA5 gene promoter methylation rates in plasma and stool of CRC patients were 60.74%, 76.60%, respectively, were higher than those of healthy persons (6.47%, 32.35%). And the differences were statistically signiifcant (P=0.006 7, P=0.000 2, respectively). GATA5 gene methylation rates in plasma of CRC patients were closely related to clinical stage (P=0.000 5) and lymph node metastasis(P=0.020), while GATA5 gene methylation rates in stool of CRC patients had no signiifcant with clinical and pathological parameters. Conclusion:Detection of faecal GATA5 gene methylation level and supplemented plasma GATA5 gene methylation level can become a simple, non-invasive, sensitive and speciifc method for clinical diagnosis of CRC.