隐孢子虫属在结直肠癌发展中的作用。
Role of Cryptosporidium spp in Development of Colorectal Cancer.
机构信息
Department of Parasitology, Medical Research Institute, Alexandria University, Egypt.
Department of Chemical Pathology, Medical Research Institute, Alexandria University, Egypt.
出版信息
Asian Pac J Cancer Prev. 2023 Feb 1;24(2):667-674. doi: 10.31557/APJCP.2023.24.2.667.
BACKGROUND
Colorectal cancer is one of the most common malignancies in humans. About 20% of the cancer incidence was attributed to infectious agents highlighting the association between infectious agents and the development of cancers. It has been suspected that Cryptosporidium spp. infection may be correlated with colon adenocarcinoma. Aim: investigate the percentage of cryptosporidiosis among colorectal cancer patients.
SUBJECTS
100 patients were recruited from Medical Research Institute, Alexandria University.
METHODS
Fresh stool specimens were collected, homogenized and examined using direct wet mount and by permanent staining of faecal smears using Modified ZN staining. Molecular detection by PCR amplification of Cryptosporidium COWP gene.
RESULTS
Significantly higher proportion of colorectal cancer patients (32.5%, 42.5%) tested positive by MZN and ELISA respectively compared to only 3.3% and 5% of positive MZN and ELISA among control group. Also, positive PCR was detected among higher proportion of colorectal cancer patients (47.5%) and only 5% of control group. Odds of colorectal cancer is 19 times among positive cases of Cryptosporidium by PCR than those without proven infection by PCR (OR 19.12; 95% CI 4.82-75.99). Comparison of the assessment of Cryptosporidium infection made by two techniques produces a kappa value of 0.770, and .759 respectively between NZN, ELISA and PCR as a gold standard, suggesting a good agreement between the two techniques and PCR. This value of kappa is significantly different from zero, K.770, p<0.001 for MZN and K.759, p<.001 for ELISA. Specificity of MZN (100%) is higher than that of ELISA (96.2%) and both reported higher specificity than sensitivity denoting that both tests are good positive to rule in the presence of infection at 40% prevalence.
CONCLUSION
Cryptosporidium infection is significantly higher among cancer colon patients reinforcing that it might be considered as a likely risk factor for the development cancer colon.
背景
结直肠癌是人类最常见的恶性肿瘤之一。约 20%的癌症发病率归因于感染因子，这突出了感染因子与癌症发展之间的关联。有人怀疑隐孢子虫感染可能与结肠癌腺癌有关。目的：调查结直肠癌患者中隐孢子虫病的比例。
对象
从亚历山大大学医学研究所招募了 100 名患者。
方法
采集新鲜粪便标本，用直接湿载片法和改良 ZN 染色法对粪便涂片进行永久染色，进行隐孢子虫 COWP 基因的 PCR 扩增。
结果
用 MZN 和 ELISA 检测，结直肠癌患者的阳性比例明显高于对照组（分别为 32.5%和 42.5%），而对照组的 MZN 和 ELISA 阳性比例分别为 3.3%和 5%。此外，在更高比例的结直肠癌患者（47.5%）中检测到阳性 PCR，而对照组仅为 5%。PCR 检测阳性的结直肠癌患者的 OR 为 19 倍（OR 19.12；95%CI 4.82-75.99）。两种技术对隐孢子虫感染的评估比较，MZN、ELISA 和 PCR 作为金标准，两者之间的 Kappa 值分别为 0.770 和 0.759，表明两种技术与 PCR 之间具有良好的一致性。这个 Kappa 值与零显著不同，MZN 为 K.770，p<0.001，ELISA 为 K.759，p<.001。MZN（100%）的特异性高于 ELISA（96.2%），两者的特异性均高于敏感性，这表明两种检测方法在 40%流行率下均能很好地作为感染的阳性指标。
结论
结直肠癌患者中隐孢子虫感染明显升高，这表明它可能被认为是结肠癌发展的一个潜在危险因素。
Zotero 插件