Objective: To explore the application value of lung cancer-related gene methylation in lung cancer diagnosis. Methods: Sixty patients with lung cancer underwent surgery were selected as the case group, and 65 patients with benign lung lesions treated in the same period were recruited as the control group. The methylation levels of lung cancer-related genes including dying-associated protein kinase (DAPK), O-6-methylguanine-DNA methyltransferase (MGMT), APC gene promoter 1A (APC1A) and epithelial mucoprotein gene (ECAD) in the blood samples of two groups of patients were analyzed by methylated PCR-specific method. The relationship between methylation of lung cancer-related genes and lung cancer was analyzed and its diagnostic value in lung cancer was evaluated. Results: The methylation detection rates of DAPK, MGMT, APC1A and ECAD in the case group were 68.3%, 68.3%, 63.3% and 65.0%, respectively, all higher than those of the control group (all P<0.05). The multivariate Logistic regression analysis showed that DAPK (OR=0.709), MGMT (OR=0.793), APC1A (OR=0.163), and ECAD (OR=2.047) were all independent influencing factors for lung cancer (all P<0.05). Analysis of the receiver operating characteristic curve showed that, the area under the curve (AUC) of DAPK, MGMT, APC1A and ECAD methylation test for lung cancer predicting were 0.623, 0.680, 0.620 and 0.648, respectively, while the AUC of the combined four gene methylation for lung cancer predicting was 0.829, higher than the AUC of each gene (all P<0.05). Conclusion: The combined methylation detection of multiple lung cancer related genes can improve the diagnostic value of lung cancer, contribute to the early diagnosis of lung cancer, and have potentially clinical application value.
目的： 探讨肺癌相关基因甲基化在肺癌诊断中的应用价值。 方法： 以60例行外科手术治疗的肺癌患者为病例组对象，65例同期住院的肺部良性病变患者为对照组。采用甲基化PCR特异性方法对两组患者的血液标本进行死亡相关蛋白激酶(DAPK)、6-氧-甲基鸟嘌呤-DNA甲基转移酶(MGMT)、APC基因启动子1A(APC1A)及上皮黏性蛋白基因(ECAD)等肺癌相关基因的甲基化检测，分析肺癌相关基因甲基化与肺癌的关系，评价肺癌相关基因甲基化对肺癌的的诊断效能。 结果： 病例组患者肺癌相关基因DAPK、MGMT、APC1A和ECAD甲基化检出率分别为68.3%、68.3%、63.3%和65.0%，均高于对照组(均P<0.05)。多因素Logistic回归分析显示，DAPK(OR＝0.709)、MGMT(OR＝0.793)、APC1A(OR＝0.163)、ECAD(OR＝2.047)均为肺癌发病的独立影响因素(均P<0.05)。采用受试者工作特征曲线分析显示，肺癌相关基因DAPK、MGMT、APC1A和ECAD甲基化检测预测肺癌的曲线下面积分别为0.623、0.680、0.620和0.648，而4种基因甲基化联合预测肺癌的AUC为0.829，均高于各基因甲基化单一预测肺癌的AUC(均P<0.05)。 结论： 多肺癌相关基因甲基化联合检测能够提高对肺癌的诊断价值，有助于肺癌的早期诊断，具有较高的临床应用价值。.
Keywords: Diagnosis; Lung neoplasms; Methylation; Related gene.