简介:摘要目的探讨血浆SEPT9基因甲基化联合血清癌胚抗原(CEA)、糖类抗原724(CA724)检测在结直肠癌诊断中的临床应用价值。方法选取2018年5月至2021年10月陕西省宝鸡市中心医院和云南省新昆华医院收治的219例结直肠病变患者,包括病理诊断结直肠癌149例、结直肠息肉70例,选择同期体检健康者100名作为健康对照组。采用实时荧光定量聚合酶链反应(PCR)测定血浆SEPT9基因甲基化状态,电化学发光法测定血清CEA和CA724的水平。比较各组3项指标表达情况,采用受试者工作特征(ROC)曲线分析3项指标单独及联合诊断结直肠癌的效果。结果结直肠癌组SEPT9基因甲基化阳性率(74.50%,111/149)高于结直肠息肉组(22.86%,16/70)和健康对照组(1.00%,1/100),差异有统计学意义(P<0.001);结直肠癌组CEA阳性率(46.98%,70/149)高于结直肠息肉组(40.00%,28/70)和健康对照组(3.00%,3/100),差异有统计学意义(P<0.001);结直肠癌组CA724阳性率(38.93%,58/149)高于结直肠息肉组(32.86%,23/70)和健康对照组(2.00%,2/100),差异有统计学意义(P<0.001)。SEPT9基因甲基化、CEA和CA724单独诊断结直肠癌的ROC曲线下面积(AUC)分别为0.823(95% CI 0.753~0.891)、0.788(95% CI 0.725~0.852)、0.689(95% CI 0.624~0.754)。SEPT9基因甲基化诊断结直肠癌的最佳临界Ct值为36.5,灵敏度为90.30%,阳性预测值为84.68%,均高于CEA和CA724;CEA诊断结直肠癌的最佳临界值为8.80 ng/ml,特异度(77.50%)和阴性预测值(78.48%)均高于SEPT9基因甲基化和CA724;3项指标联合检测的临界值取3项指标单项最佳临界值时的灵敏度(97.66%)、阳性预测值(93.98%)、阴性预测值(81.25%)、AUC(0.846,95% CI 0.749~0.944)均较单项指标高。结论血浆SEPT9基因甲基化、血清CEA和CA724联合检测诊断结直肠癌,灵敏度和准确度高,三者可以优势互补,提高诊断效率,对于结直肠癌的诊断具有较高的临床价值。
简介:AbstractHepatitis D virus (HDV) infection causes the most severe form of viral hepatitis with rapid progression to cirrhosis, hepatic decompensation, and hepatocellular carcinoma. Although discovered > 40 years ago, little attention has been paid to this pathogen from both scientific and public communities. However, effectively combating hepatitis D requires advanced scientific knowledge and joint efforts from multi-stakeholders. In this review, we emphasized the recent advances in HDV virology, epidemiology, clinical feature, treatment, and prevention. We not only highlighted the remaining challenges but also the opportunities that can move the field forward.