RASSF1A基因甲基化和SCC联合检测在非小细胞肺癌转移监测中的应用

摘要

Objective To explore the prognostic value of combined analysis of squamous cell carci-noma antigen(SCC)and DNA methylation of ras association domain family 1A(RASSF1A)in patients with non-small cell lung cancer (NSCLC). M ethods A total of 57 NSCLC patients treated in the second hospital of Longyan from January 2014 to June 2015 were enrolled.DNA methylation of RASSF1A in plasma,serum lev-els of SCC before operation,and DNA methylation of RASSF1A in tissue after the operation were determined. The patients were all followed up for 12 months and divided into 2 groups, the metastatic group and the non-metastatic group. The relationships among the levels of SCC, DNA methylation of RASSF1A and metastasis events were analyzed. R esults Compared with the non-metastatic group,the levels of SCC and DNA meth-ylation of RASSF1A were significantly increased in the metastatic group.According to ROC curve analysis,the serum levels of SCC and DNA methylation of RASSF1A matched up to the prognostic condition for the metasta-sis events.The SCC level was 4.05 ng/mL,DNA methylation of RASSF1A in tissue was positive as the cut-off point for risk stratification,the Kaplan-Meier survival curve revealed that there was a significant difference be-tween high risk and low risk patients for metastasis events occurrence in NSCLC patients (P<0.05). C onclusion The higher the level of serum SCC and DNA methylation of RASSF1A in the tumor tissue of NSCLC patients,the higher the risk of postoperative metastasis.Increased levels of SCC and DNA methylation of RASSF1A could predict the prognosis at certain degree for NSCLC patients.%目的 探讨Ras相关结构域蛋白家族1A(ras association domain family 1A,RASSF1A)基因甲基化和鳞状上皮细胞癌抗原(squamous cell carcinoma antigen,SCC)联合检测对非小细胞肺癌(non-small cell lung cancer,NSCLC)患者术后转移评价的价值. 方法 选择2014年1月至2015年6月在龙岩市第二医院就诊的57例NSCLC患者,测定患者术前血浆RASSF1A基因甲基化、血清SCC水平,同时检测患者术后肿瘤组织RASSF1A基因甲基化水平.出院后随访12个月,根据随访结果分为转移组和非转移组,分析两组血浆及组织RASSF1A基因甲基化阳性率、术前血清SCC水平与术后转移的关系. 结果 发生转移的患者术前血清SCC水平、术后组织和术前血浆RASSF1A甲基化阳性率均高于未发生转移的患者,差异有统计学意义(P<0.05).根据肿瘤组织RASSF1A基因甲基化、术前血清SCC水平对NSCLC患者术后转移判定的ROC曲线,NSCLC患者肿瘤组织RASSF1A基因甲基化、术前血清SCC水平符合预测NSCLC术后转移的条件.将SCC水平4.05 ng/mL、RASSF1A甲基化阳性作为危险分层界值,绘制Kaplan-Meier生存曲线显示,高危组与低危组两组术后转移比较差异具有统计学意义(P<0.05). 结论 NSCLC患者肿瘤组织RASSF1A基因甲基化、术前血清SCC水平越高,发生术后转移的风险越高,检测NSCLC患者肿瘤组织RASSF1A基因甲基化、术前血清SCC水平对NSCLC患者危险分层及术后转移评估具有一定的临床价值.