Tang Haoran, Ma Xudong, Zhou Lin, Li Wei, Shu Yixiong, Xu Haichao, Li Jiang, Wang Feng, Sun Feng, Duan Yongqing
Department of Gastrointestinal Surgery, the Second Affiliated Hospital of Kunming Medical University, Kunming, P.R. China.
Blood Transfusion Department, the Second Affiliated Hospital of Kunming Medical University, Kunming, P.R. China.
Genet Test Mol Biomarkers. 2022 Apr;26(4):239-248. doi: 10.1089/gtmb.2021.0127.
The performance of methylated in lower gastrointestinal (GI) cancer (colorectal cancer) has been extensively investigated; however, its performance in upper GI cancer (esophageal cancer and gastric cancer) and the comparison with lower GI cancer have rarely been studied. A total of 1854 subjects, including 344 upper GI cancer patients, 459 lower GI cancer patients, and 1051 noncancer subjects, were recruited in this prospective cohort study. A modified single polymerase chain reaction test for detecting was used for plasma detection. The sensitivity of for upper and lower GI cancers was 45.3% and 74.8%, and the corresponding specificities were 85.6% and 86.5%, with areas under curve (AUC) of 0.71 and 0.80, respectively. exhibited lower sensitivity in stage I than stage II-IV cancer, while no difference in sensitivity was observed for different locations in upper or lower GI cancer. No difference in sensitivity was found among gross classifications, pathological classifications, and differentiation in upper GI cancer, but a higher sensitivity in infiltrative cancer and moderate and poorly differentiated cancers was observed in the lower GI. No difference in sensitivity was found between male and female in both cancers, while sensitivity increased with age for both cancers. Cancer antigen 724 (CA724) showed the highest sensitivity for upper GI cancers, and carcinoembryonic antigen (CEA) showed the highest sensitivity for lower GI cancers. The combination of CA724 with increased the sensitivity to 67.5% in upper GI cancers, and the combination of with CEA increased the sensitivity to 85.4% in lower GI cancers, with an AUC of 0.90 and 0.95, respectively. exhibited a higher sensitivity in lower GI cancers than upper GI cancers. The combination of with protein markers significantly enhanced the detection sensitivity in both cancers.
甲基化在低位胃肠道（GI）癌（结直肠癌）中的表现已得到广泛研究；然而，其在上位胃肠道癌（食管癌和胃癌）中的表现以及与低位胃肠道癌的比较却鲜有研究。在这项前瞻性队列研究中，共招募了1854名受试者，包括344名上位胃肠道癌患者、459名低位胃肠道癌患者和1051名非癌症受试者。采用改良的单聚合酶链反应试验检测甲基化用于血浆检测。甲基化对上、低位胃肠道癌的敏感性分别为45.3%和74.8%，相应的特异性分别为85.6%和86.5%，曲线下面积（AUC）分别为0.71和0.80。甲基化在I期癌症中的敏感性低于II-IV期癌症，而上、低位胃肠道癌不同部位的敏感性未观察到差异。在上位胃肠道癌中，大体分类、病理分类和分化程度之间的敏感性没有差异，但在低位胃肠道癌中，浸润性癌以及中、低分化癌的敏感性较高。两种癌症中男性和女性的敏感性没有差异，而两种癌症的敏感性均随年龄增加。癌抗原724（CA724）在上位胃肠道癌中显示出最高敏感性，癌胚抗原（CEA）在低位胃肠道癌中显示出最高敏感性。CA724与甲基化联合使用可使上位胃肠道癌的敏感性提高到67.5%，甲基化与CEA联合使用可使低位胃肠道癌的敏感性提高到85.4%，AUC分别为0.90和0.95。甲基化在低位胃肠道癌中的敏感性高于上位胃肠道癌。甲基化与蛋白质标志物联合使用可显著提高两种癌症的检测敏感性。
