Cao Chang-Qi, Chang Lin, Wu Qi
Department of Endoscopy Center, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Beijing, China.
Transl Cancer Res. 2020 Nov;9(11):7012-7021. doi: 10.21037/tcr-20-1330.
Gastric cancer (GC) has a poor prognosis due to patients often being diagnosed at an advanced stage, when metastasis has already occurred. To improve the 5-year survival rate and reduce the number of cancer-related deaths in patients with GC, noninvasive methods for early detection need to be developed. This study aimed to evaluate the value of circulating methylated Septin 9 () and ring finger protein 180 () for the early diagnosis of GC.
Seventy-four patients with early GC, 99 patients with benign gastric diseases (BGD) (inflammation, polyps, intestinal metaplasia, ulcers, and erosion), and 57 cases with no evidence of disease (NED) were enrolled. Methylated and in circulating cell-free DNA in blood samples from each group were detected, and the positivity rates were calculated. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), confidence interval (CI), and area under the curve (AUC) were determined for methylated and in relation to early GC.
As a diagnostic target, methylated had a sensitivity of 28.3% (95% CI: 18.5-40.0%), specificity of 94.2% (95% CI: 89.3-97.3%), and AUC value of 0.616 (95% CI: 52.0-71.1%). Methylated had a sensitivity of 32.4% (95% CI: 22.0-44.3%), specificity of 89.7% (95% CI: 83.9-94.0%), and AUC value of 0.636 (95% CI: 54.2-73.0%). A combination of the two yielded a sensitivity of 40.5% (95% CI: 29.3-52.6%), specificity of 85.3% (95% CI: 78.7-90.4%), and AUC value of 0.65 (95% CI: 55.7-74.4%).
Methylated and could be used as diagnostic biomarkers for early gastric cancer (EGC).
由于胃癌（GC）患者常被诊断为晚期，此时已发生转移，其预后较差。为提高GC患者的5年生存率并减少癌症相关死亡人数，需要开发早期检测的非侵入性方法。本研究旨在评估循环甲基化Septin 9（）和环指蛋白180（）对GC早期诊断的价值。
纳入74例早期GC患者、99例良性胃部疾病（BGD）（炎症、息肉、肠化生、溃疡和糜烂）患者以及57例无疾病证据（NED）的病例。检测每组血液样本中循环游离DNA中的甲基化和，计算阳性率。确定甲基化和与早期GC相关的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）、置信区间（CI）和曲线下面积（AUC）。
作为诊断指标，甲基化的敏感性为28.3%（95%CI：18.5 - 40.0%），特异性为94.2%（95%CI：89.3 - 97.3%），AUC值为0.616（95%CI：52.0 - 71.1%）。甲基化的敏感性为32.4%（95%CI：22.0 - 44.3%），特异性为89.7%（95%CI：83.9 - 94.0%），AUC值为0.636（95%CI：54.2 - 73.0%）。两者联合使用时，敏感性为40.5%（95%CI：29.3 - 52.6%），特异性为85.3%（95%CI：78.7 - 90.4%），AUC值为0.65（95%CI：55.7 - 74.4%）。
甲基化和可作为早期胃癌（EGC）的诊断生物标志物。
