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目的探讨尿核苷检测对结直肠癌的诊断价值及在手术治疗监测中的应用。方法采用反相高效液相色谱法检测经结肠镜与活检病理证实的52例结直肠癌患者术前1天与术后第8天尿中14种正常与修饰核苷水平,同时以62例健康人作为对照组,并与传统肿瘤标记物癌胚抗原(CEA),CA199,CA125,甲胎蛋白(AFP)相比较,探讨尿核苷与结直肠癌临床病理特征的关系。结果结直肠癌组14种核苷中假尿嘧啶核苷(Pseu),腺嘌呤核苷(A),胞嘧啶核苷(C),1甲基腺苷(m1A),1甲基次黄嘌呤核苷(m1I),3甲基尿苷+5甲基尿苷(mU),2,2二甲基鸟苷(m22G),次黄嘌呤核苷(I),1甲基鸟苷(m1G),N4乙酰胞苷(ac4C),6甲基腺苷(m6A)等11种核苷水平显著升高,与正常对照组相比差异具有统计学意义(P<0.05);通过主成分分析,76.9%(40/52)的结直肠癌患者被正确识别,敏感性与传统标记物CEA(38.5%),CA199(40.4%),CA125(15.4%),AFP(17.3%)相比差异有统计学意义(均P<0.01);Pseu与m1G的受试者操作特征曲线下面积分别达到0.896与0.816;对8种核苷(Pseu,m1A,m1I,m22G,I,m1G,ac4C,m6A)进行逐步判别分析,发现Pseu、m1G在判别分析中有统计学意义,建立判别函数Y正常人=-3.009+0.0272×Pseu+4.918×m1G,Y结直肠癌=-8.057+0.0667×Pseu+8.258×m1G;40例结直肠癌患者的Pseu,C,U(尿嘧啶核苷)
Objective To investigate the diagnostic value of uridine in colorectal cancer and its application in the monitoring of surgical treatment. Methods Fifty-two normal and modified nucleosides in urine of 52 patients with colorectal cancer confirmed by colonoscopy and biopsy were assayed by RP-HPLC at day 1 before operation and on day 8 postoperatively. Sixty-two healthy subjects As control group, and compared with the traditional tumor markers carcinoembryonic antigen (CEA), CA199, CA125, AFP (AFP) to explore the relationship between uridine and colorectal cancer clinicopathological features. Results Among 14 nucleosides of colorectal cancer group, Pseu, A, C, MIA and 1-methylhypoxanthine (M1I), 3 methyluridine + 5 methyluridine (mU), 2,2 dimethyl guanosine (m22G), inosine (I), 1 methylguanosine (m1G) , N4 acetyl-cytidine (ac4C) and 6-methyl adenosine (m6A) were significantly increased compared with the normal control group (P <0.05). By principal component analysis, 76.9 (40/52) of colorectal cancer patients were correctly identified. The sensitivity was statistically different from the traditional markers of CEA (38.5%), CA199 (40.4%), CA125 (15.4%) and AFP (P <0.01). The area under the operating characteristic curve of subjects with Pseu and m1G reached 0.896 and 0.816, respectively. Eight nucleosides (Pseu, m1A, m1I, m22G, I, m1G, ac4C and m6A) Discriminant analysis showed that Pseu and m1G were statistically significant in discriminant analysis. The discriminant function was established as Y = -3.009 + 0.0272 × Pseu + 4.918 × m1G, Y colorectal cancer = -8.057 + 0.0667 × Pseu + 8.258 × m1G; 40 cases of colorectal cancer patients with Pseu, C, U (uridine)