CAJ | 학술논문

目的：探讨非小细胞肺癌患者血清中8个抑癌基因启动子C pG岛甲基化的联合检测在诊断非小细胞肺癌患者中的意义，以期提高非小细胞肺癌早期无创检出率，提升治愈率。方法选取62例非小细胞肺癌患者设为肺癌组，选取30例肺部良性疾病患者作为对照组，选取16例健康者作为健康组，取3个组研究对象的血清采取癌基因测序法检测8种基因启动子区域甲基化情况，比较3个组研究对象的上述指标，分析上述指标的变化和3个组研究对象不同临床状态的相关性。结果肺组结肠腺瘤性息肉病基因（A PC ）、钙粘蛋白13（CD H 13）、死亡相关蛋白激酶基因（DAPK）、人类O6-甲基鸟嘌呤-DNA-甲基转移酶（MGMT）、RAS相关区域家族 F2（RASSF2）、人类Runt相关转录因子3（RUNX3）、RAS相关区域家族1A （RASSF1A）和TMS1/ASC基因甲基化检出率均明显高于对照组，组间比较差异具有统计学意义（P＜0．05），非小细胞肺癌患者血清中抑癌基因8个指标联合检测敏感性达到93．54％，特异性达到90．3％，敏感性明显高于所有单项检测和4个指标联合检测。结论 A PC、CD H 13等8个抑癌基因异常甲基化状态的联合检测可以明显提高非小细胞肺癌患者抑癌基因甲基化的检出率。该8个基因异常甲基化有望成为非小细胞肺癌辅助诊断和预后判断的分子标记，并有可能成为非小细胞肺癌治疗的新靶点，从而提高临床对非小细胞肺癌患者的诊治水平。
목적：탐토비소세포폐암환자혈청중8개억암기인계동자C pG도갑기화적연합검측재진단비소세포폐암환자중적의의，이기제고비소세포폐암조기무창검출솔，제승치유솔。방법선취62례비소세포폐암환자설위폐암조，선취30례폐부량성질병환자작위대조조，선취16례건강자작위건강조，취3개조연구대상적혈청채취암기인측서법검측8충기인계동자구역갑기화정황，비교3개조연구대상적상술지표，분석상술지표적변화화3개조연구대상불동림상상태적상관성。결과폐조결장선류성식육병기인（A PC ）、개점단백13（CD H 13）、사망상관단백격매기인（DAPK）、인류O6-갑기조표령-DNA-갑기전이매（MGMT）、RAS상관구역가족 F2（RASSF2）、인류Runt상관전록인자3（RUNX3）、RAS상관구역가족1A （RASSF1A）화TMS1/ASC기인갑기화검출솔균명현고우대조조，조간비교차이구유통계학의의（P＜0．05），비소세포폐암환자혈청중억암기인8개지표연합검측민감성체도93．54％，특이성체도90．3％，민감성명현고우소유단항검측화4개지표연합검측。결론 A PC、CD H 13등8개억암기인이상갑기화상태적연합검측가이명현제고비소세포폐암환자억암기인갑기화적검출솔。해8개기인이상갑기화유망성위비소세포폐암보조진단화예후판단적분자표기，병유가능성위비소세포폐암치료적신파점，종이제고림상대비소세포폐암환자적진치수평。
Objective To investigate the clinical significance of combined detection of promoter CpG island methylation in eight tumor suppressor genes in serum of patients with non-small cell lung cancer cliserum of patients with non-small cell lung cancer (NSCLC) .Methods A total of 62 patients with NSCLC were enrolled as lung cancer group ,30 patients with benign lung disease were enrolled as control group ,and 16 healthy subjects were enrolled as healthy group .Serum samples of all groups were collected and detected for promoter region methylation of eight genes by using cancer gene sequencing assay .Detection results were compared between the three groups ,and associa-tion between changes of these indicators and clinical state of patients were analyzed .Results Detection rates of pro-moter region methylation of adenomatous polyposis colii (APC) gene ,cadherin 13 (CDH 13) gene ,death-associated protein kinase (DAPK) gene ,human O6 methylguanine DNA methyltransferase (MGMT) gene ,Ras association do-main family F2 (RASSF2) gene ,runt-related transcription factor 3 (RUNX3) gene ,Ras association domain family F1A (RASSF1A) gene and TMS1/ASC gene in NSCLC group were significantly higher than control group (P<0 .05) .The sensitivity and specificity of combined detection of these eight indicators in NSCLC patients were 93 .54%and 90 .3% ,and the sensitivity was significantly higher than individual test and combined detection of four indicators . Conclusion Combined detection of promoter region methylation of eight tumor suppressor genes ,including APC , CDH 13 and so on ,could improve the detection rate of tumor suppressor gene methylation in patients with NSCLC , indicating that hypermethylation of there eight genes could be useful for the diagnosis and prognosis of NSCLC , which could be new molecular markers for the therapy of NSCLC to improve the level of diagnosis and therapy of NSCLC .