Department of Pulmonary and Critical Care Medicine, Affiliated Suzhou Municipal Hospital of Nanjing Medical University, Jiangsu, China.
Medicine (Baltimore). 2023 Sep 8;102(36):e34955. doi: 10.1097/MD.0000000000034955.
To evaluate the diagnostic value of exfoliated tumor cells (ETCs) numbers combined with DNA methylation levels in bronchoalveolar lavage fluid (BALF) in lung cancer.
BALF samples were collected from 43 patients with lung cancer and 23 with benign lung disease. ETCs were detected by the nano-enrichment method, and the methylation status of the short stature homeobox gene 2 (SHOX2) and the RAS association domain family 1, isoform A (RASSF1A) gene were detected by RT-PCR. The diagnostic value of each metric was evaluated by receiver operating characteristic curve analysis, specificity and sensitivity.
The sensitivity/specificity of RASSF1A and SHOX2 methylation detection were 44.12%/76.47% and 93.75%/87.50%, respectively. When "RASSF1A/SHOX2 methylation" was used as a positive result, the sensitivity increased to 88.24%, and the specificity decreased to 81.25%. When "RASSF1A + SHOX methylation" was used as positive, the sensitivity was reduced to 32.35%, but the specificity was increased to 100.00%. The sensitivity and specificity of ETCs detection in BALF were 89.47% and 16.67%, respectively. When "SHOX2/RASSF1A methylation + ETCs was used as a positive result, the sensitivity and specificity of the detection were 79.31% and 81.82%, respectively. When "SHOX2 + RASSF1A + ETCs" was used as positive, the sensitivity was 34.48% and the specificity was 90.91%. Receiver operating characteristic curve analysis showed that when SHOX2, RASSF1A methylation and ETCs were combined, the diagnostic sensitivity increased to 0.778.
ETCs counting in combination with SHOX2 and RASSF1A methylation assays in BALF samples has demonstrated excellent sensitivity for lung cancer diagnosis and is an effective complementary tool for clinical diagnosis of lung cancer.
评估肺泡灌洗液（BALF）中脱落肿瘤细胞（ETCs）数量与 DNA 甲基化水平联合用于肺癌诊断的价值。
收集 43 例肺癌患者和 23 例良性肺部疾病患者的 BALF 样本。采用纳米富集法检测 ETCs，采用 RT-PCR 检测短缩体 homeobox 基因 2（SHOX2）和 RAS 相关结构域家族 1，同种型 A（RASSF1A）基因的甲基化状态。通过受试者工作特征曲线分析、特异性和敏感性评估每种指标的诊断价值。
RASSF1A 和 SHOX2 甲基化检测的敏感性/特异性分别为 44.12%/76.47%和 93.75%/87.50%。当将“RASSF1A/SHOX2 甲基化”作为阳性结果时，敏感性增加至 88.24%，特异性降低至 81.25%。当将“RASSF1A+SHOX 甲基化”作为阳性结果时，敏感性降低至 32.35%，但特异性增加至 100.00%。BALF 中 ETCs 检测的敏感性和特异性分别为 89.47%和 16.67%。当将“SHOX2/RASSF1A 甲基化+ETCs”作为阳性结果时，检测的敏感性和特异性分别为 79.31%和 81.82%。当将“SHOX2+RASSF1A+ETCs”作为阳性结果时，敏感性为 34.48%，特异性为 90.91%。受试者工作特征曲线分析显示，当 SHOX2、RASSF1A 甲基化和 ETCs 联合时，诊断敏感性增加至 0.778。
BALF 样本中 ETCs 计数联合 SHOX2 和 RASSF1A 甲基化检测对肺癌诊断具有优异的敏感性，是肺癌临床诊断的有效补充工具。
