| Objective:To explore the diagnostic value of fecal syndecan-2(SDC2)gene methylation in the early screening of colorectal cancer,and to explore whether this detection method has higher clinical value in the screening of colorectal cancer in diabetic population.Methods:From September 2021 to September 2022,100 patients with positive fecal occult blood combined with diabetes in Baoding First Central Hospital were selected as the diabetes group,and 100 patients with pure fecal occult blood were selected as the control group.All patients underwent colonoscopy.Diabetes diagnosis was based on the Guidelines for the Prevention and Treatment of Type 2 Diabetes in China(2020 Edition);All enrolled patients took fecal samples before colonoscopy for the detection of fecal SDC2 gene methylation.According to the results of colonoscopy and pathology,Divided into colorectal cancer,advanced adenoma,non-advanced colorectal tumor,and no abnormality.The diagnosis of colonoscopic lesions was based on the Guidelines for Screening and Endoscopic Diagnosis and Treatment of Early Colorectal Cancer in China(2014,Beijing).χ 2 test or Fisher’s exact probability method were used to compare the microscopic detection rate of colorectal cancer and advanced adenoma and the positive rate of fecal SDC2 gene methylation between the two groups,and to analyze the sensitivity and specificity of fecal SDC2 gene methylation in detecting colorectal cancer and advanced adenoma.ROC curve was used to evaluate the diagnostic efficacy of fecal detection in colorectal cancer.To investigate its clinical value in early screening of colorectal cancer in patients with type 2 diabetes.Results:1.Comparison of general dataA total of 175 subjects were included in this study,and 167 qualified fecal samples were finally collected(including 8 cases of colorectal cancer,6 cases of fecal sample collection were unqualified,1 case leaked fluid,and1 case did not complete colonoscopy),including 91 cases in the diabetes group,including 5 cases of colorectal cancer,20 cases of advanced adenoma,30 cases of non-advanced colorectal tumor,36 cases of no abnormality,and76 cases of control group,including 3 cases of colorectal cancer,14 cases of advanced adenoma,non-advanced colorectal tumor There were 22 cases of advanced colorectal tumors and 37 cases of no abnormalities.There were no statistically significant differences in gender,age,lesion location,and underlying diseases between the two groups(P>0.05).2.Comparison of colonoscopy detection rate of colorectal cancer and precancerous lesions between control group and diabetic groupThere was no significant difference in the detection rate of colorectal cancer between the diabetes group and the control group(5.5% vs 3.9%,P=0.729);there was no significant difference in the detection rate of advanced adenoma(22.2% vs 18.4%,P=0.700).3.Relationship between fecal SDC2 gene methylation and clinical characteristics in control group and diabetic groupThe results showed that there was no significant difference in the positive rate of fecal SDC2 gene methylation between the two groups in terms of gender,age,tumor location,and underlying disease(P>0.05).4.Comparison of fecal SDC2 gene positive rate between diabetic group and control groupSince fecal SDC2 gene detection is mainly aimed at colorectal cancer and advanced adenoma,non-advanced colorectal tumors and those without abnormality after colonoscopy were all classified as the non-abnormal group.The positive rate of SDC2 gene methylation detection in the stool of colorectal cancer in the diabetes group was significantly higher than that in the advanced adenoma and no abnormality group,and the difference was statistically significant(P<0.05);the positive rate of colorectal cancer in the control group was significantly higher than that in the control group.In the no abnormality group,the difference was statistically significant(P<0.05);in the control group,there was no significant difference in the positive rate of colorectal cancer and advanced adenoma(P>0.05);The positive rate of detection was higher than that of the control group(80.0% vs 66.7%),and the difference was not statistically significant(P>0.05).5.Efficacy of fecal SDC2 gene methylation in the diagnosis of colorectal cancerThe results of ROC curve analysis showed that the areas under the curve(AUC)of the control group,the diabetes group and the overall detection of fecal SDC2 gene methylation in the diagnosis of colorectal cancer were 0.872,0.888 and 0.890,respectively.The sensitivities of overall fecal SDC2 gene methylation detection were 66.7%,80.0%,75.0%,and the specificities were 98.6%,93.0%,93.7%,respectively.Conclusions:1.Fecal SDC2 gene methylation has a higher clinical diagnostic value in the screening of colorectal cancer in diabetic patients than in the control group,providing a new detection method for screening colorectal cancer in diabetic patients.2.Fecal SDC2 gene methylation has high sensitivity and specificity in the diagnosis of colorectal cancer,and has good diagnostic performance in colorectal cancer screening. |
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