ABSTRACT
Objective:To investigate the methylation status of SDC2, PPP2R5C and ADHFE1 genes in stool and their values in the screening of colorectal cancer and precancerous lesions.Methods:From August 2020 to March 2021, 64 patients with colorectal cancer, 72 patients with adenoma, 33 patients with hyperplastic polyps and 59 healthy people were recruited from Qingdao Central Hospital Affiliated to Qingdao University, and the morning stool samples were collected from the research subjects. The genomic DNA was extracted and modified with sulfite. The methylation status of SDC2, PPP2R5C and ADHFE1 genes were detected by methylation specific polymerase chain reaction (MSP), and the fecal occult blood test (FOBT) was performed. Taking the pathological results as the gold standard, receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to compare the effect of combined detection of methylation of three genes and FOBT in predicting colorectal cancer and precancerous lesions. R-Studio software was used to construct a nomogram for the prediction of colorectal cancer with combined detection of gene methylation in stool and other clinical features, and the calibration and validation were performed.Results:The positive rates of combined detection of methylation of SDC2, PPP2R5C and ADHFE1 genes in stool were higher than those of FOBT in colorectal cancer+adenoma [74.3% (101/136) vs. 47.1% (64/136), χ2 = 23.20, P = 0.001], colorectal cancer [90.6% (58/64) vs. 70.3% (45/64), χ2 = 8.91, P = 0.003] and adenoma [59.7% (43/72) vs. 26.4% (19/72), χ2 = 14.43, P = 0.002]. There was no significant difference in the positive rates in hyperplastic polyps [21.2% (7/33) vs. 6.1% (2/33), χ2 = 0.12, P = 0.125] and healthy controls [10.2% (6/59) vs. 8.5% (5/59), χ2 = 4.01, P = 1.000]. The combined detection of gene methylation was better than FOBT in the prediction of colorectal cancer + adenoma [AUC: 0.85 (95% CI 0.80-0.91) vs. 0.71 (95% CI 0.64-0.78), P < 0.05], especially in the prediction of adenoma [AUC: 0.82 (95% CI 0.74-0.89) vs 0.64 (95% CI 0.57-0.69), P < 0.001]. The sensitivity and specificity of ADHFE1 gene methylation status in predicting colorectal cancer were high (90.6% and 96.6%). In colorectal cancer patients over 50 years old, the positive rate of combined detection of gene methylation was higher than that of FOBT [90.2% (55/61) vs. 68.9% (42/61), P < 0.05]. The nomogram calibration curve for predicting colorectal cancer constructed based on the combined detection of gene methylation and each clinical feature showed a high degree of concordance between the predicted and observed diagnostic performance of colorectal cancer. Conclusions:The methylation levels of SDC2, PPP2R5C AND ADHFE1 genes in stool are increased in patients with colorectal cancer or adenoma. The combined detection of gene methylation is expected to be a non-invasive method for the screening of colorectal cancer and precancerous lesions.
ABSTRACT
Objective To investigate the effect of placing subcutaneous drain tube and preseting triclosan-coated polyglactin 910 suture with delayed suturing to incision infection after typeⅢabdominal surgery. Methords Dividing 504 patients with typeⅢincisions undergone abdominal surgery into 3 groups. The number of group A patients with thoroughly incision washing and primary triclosan-coated polyglactin 910 suture after abdominal surgery was 143. The number of group B with closed anterior rectus sheath, opened skin and subcutaneous fat with preseted triclosan-coated polyglactin 910 suture was 190. The number of group C with subcutaneous drain tube after abdominal surgery was 171. We compared the incidence rates of incision infection and the second phase debridement suture rates among the 3 groups. Results For the group A, B, C, the number of incision infection people was 11, 4, 3 and the incision infection rate was 7.69%, 2.11%and 1.75%respectively. The difference of the 3 groups incision infection rate were statistically significant (P<0.05). The incision infection rate of the group B and group C were lower than that of group A and the difference were statistically significant (P<0.016 7). There were no significant differences in second phase debridement suture rates among the 3 groups. Conclusion Preseting triclosan-coated polyglactin 910 suture with delayed incision sutue and placing subcutaneous drain tube can decrease the incision infection rates for type Ⅲpatients after abdominal surgery, but can not decrease the second phase debridement suture rates of the infectious incision.