Department of Laboratory, The First People's Hospital of Yulin, 495 Middle Education Road, Yulin, 537000, Guangxi Zhuang Autonomous Region, China.
Department of Laboratory, Yulin Women and Children Health Care Hospital, 290 Qing Ning Road, Yulin, 537000, Guangxi Zhuang Autonomous Region, China.
Int J Colorectal Dis. 2024 Sep 17;39(1):142. doi: 10.1007/s00384-024-04713-9.
The aim of this study is to evaluate the significance of combined detection of Septin9 and syndecan-2 (SDC2) methylation markers and serum tumor markers for the early diagnosis of colorectal cancer.
A total of 116 patients diagnosed with colorectal cancer between December 2022 and February 2024 were designated as the colorectal cancer group. Additionally, 31 patients with colorectal adenoma were assigned to the adenoma group, while 44 individuals undergoing routine physical examinations were included in the control group. Concentrations of Septin9, SDC2, fecal occult blood (FOB), and four tumor markers-carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), carbohydrate antigen 125 (CA125), and carbohydrate antigen 724 (CA724)-were measured. Diagnostic performance was assessed using receiver operating characteristic (ROC) curves for Septin9, SDC2, the four tumor markers, FOB, the combination of Septin9 and SDC2, and the combined use of all seven indicators (CEA, CA19-9, CA125, CA72-4, FOB, Septin9, and SDC2).
The colorectal cancer group exhibited the highest positive rates for Septin9, SDC2, the four tumor markers, the combined detection of Septin9 and SDC2, and the combined detection of all seven indicators, compared to both the adenoma and control groups (P < 0.05). The adenoma group also showed higher positive rates than the control group (P < 0.05). For patients with stage I-III colorectal cancer, the positive rates for the combined detection of Septin9 and SDC2 were 81.3%, 78.9%, and 90.2%, respectively, surpassing those for the combined detection of the four tumor markers (43.8%, 55.3%, and 61.0%). Additionally, the positive rates for the two-gene combination in stage III colorectal cancer were higher than those for FOB (P < 0.05). The sensitivity and area under the curve (AUC) for SDC2 were 73.3% and 0.855, respectively, exceeding the sensitivity and AUC for the combined four tumor markers, which were 60.3% and 0.734 (P < 0.05). The combined detection of the two methylated genes demonstrated a sensitivity of 86.2% and an AUC of 0.908, outperforming both FOB and the combined detection of the four tumor markers (P < 0.05).
The detection of SDC2 exhibits high sensitivity for colorectal cancer, and when combined with Septin9, it significantly enhances the diagnostic accuracy for early-stage colorectal cancer, offering substantial clinical value.
本研究旨在评估 Septin9 和 syndecan-2（SDC2）甲基化标志物联合检测以及血清肿瘤标志物对结直肠癌早期诊断的意义。
选取 2022 年 12 月至 2024 年 2 月期间确诊的 116 例结直肠癌患者作为结直肠癌组，另选取 31 例结直肠腺瘤患者作为腺瘤组，44 例常规体检者作为对照组。检测 Septin9、SDC2、粪便潜血（FOB）和 4 种肿瘤标志物[癌胚抗原（CEA）、糖类抗原 199（CA199）、糖类抗原 125（CA125）和糖类抗原 724（CA724）]的浓度。使用受试者工作特征（ROC）曲线评估 Septin9、SDC2、4 种肿瘤标志物、FOB、Septin9 和 SDC2 联合检测以及所有 7 项指标（CEA、CA19-9、CA125、CA72-4、FOB、Septin9 和 SDC2）的诊断性能。
结直肠癌组的 Septin9、SDC2、4 种肿瘤标志物、Septin9 和 SDC2 联合检测以及所有 7 项指标联合检测的阳性率均高于腺瘤组和对照组（P<0.05），腺瘤组也高于对照组（P<0.05）。对于Ⅰ-Ⅲ期结直肠癌患者，Septin9 和 SDC2 联合检测的阳性率分别为 81.3%、78.9%和 90.2%，高于 4 种肿瘤标志物联合检测的阳性率（43.8%、55.3%和 61.0%）。此外，在Ⅲ期结直肠癌患者中，两基因联合检测的阳性率高于 FOB（P<0.05）。SDC2 的灵敏度和曲线下面积（AUC）分别为 73.3%和 0.855，高于 4 种肿瘤标志物联合检测的灵敏度和 AUC（60.3%和 0.734）（P<0.05）。两个甲基化基因的联合检测灵敏度为 86.2%，AUC 为 0.908，均优于 FOB 和 4 种肿瘤标志物联合检测（P<0.05）。
SDC2 检测对结直肠癌具有较高的灵敏度，与 Septin9 联合使用可显著提高早期结直肠癌的诊断准确性，具有重要的临床价值。
