粪便RNA的检测在大肠癌早期诊断中的应用

大肠癌是胃肠道恶性肿瘤之一,在我国大肠癌的发病率和死亡率呈上升趋势。由于死亡率与大肠癌的诊断时间密切相关,因此早期诊断大肠癌尤为重要。但是目前临床常规诊断方法存在一定的局限性,难以实现大肠癌的早期诊断。粪便RNA检测技术是近年来发展的基于分子水平的早期无创检测大肠癌的技术,与常规检测技术包括结肠镜检测、大便隐血检测和粪便DNA突变检测相比,粪便RNA检测具有成本低和灵敏度高等优点,并可同时分析多种基因表达量和动态监测肿瘤进展。文章介绍了粪便RNA检测的可行性,系统阐述了用于粪便RNA检测的特异性基因、粪便RNA的提取方法和粪便RNA的检测技术,并对粪便RNA检测技术在大肠癌早期诊断中的进一步应用进行了展望。     

基于免疫磁珠富集粪便脱落细胞的大肠癌筛选法

大肠癌是目前发病率、致死率均较高的恶性肿瘤,严重危害人民健康生活.现有的临床检测技术均存在一定的局限性,因而限制了其临床应用的范围.与常规临床大肠癌检测相比,粪便脱落细胞检测法具有高特异性、高灵敏性且容易被受试者接受等显著优点.作为最新型的脱落细胞检测法一免疫磁珠富集粪便脱落细胞检测法除具有一般脱落细胞检测法的优点外,还具有细胞回收效率高、肿瘤细胞特异性高等优点.本文阐述了脱落细胞检测大肠癌的原理和基本方法,着重介绍了免疫磁珠富集脱落细胞的原理和操作过程以及针对脱落细胞进行大肠癌检测的多种方法,并对全自动、快速、高通量的自动化脱落细胞检测仪器应用于脱落细胞检测进行了展望.     

一种检测kras基因突变的新型TB-ARMS qPCR方法的建立

在荧光定量PCR基础上建立一种简单有效并且高度灵敏的TB-ARMSkras基因突变检测方法,并对其检测性能进行评估,探讨其临床应用价值。针对kras基因8种常见的点突变类型,通过设计并优化突变特异性引物、野生型特异性封闭引物并综合应用突变富集扩增反应条件等多种手段,提高点突变检测的灵敏度和特异性,采用已知野生型基因组样品和构建的突变质粒作为标准品,进行方法学评价;通过对临床样本的检测及与现有商品化试剂盒的比较进行性能验证;通过对术前血浆和配对组织样品的对比检测,评估方法是否适用于血液样本的检测。建立了TB-ARMS kras突变检测的新方法,能检测的最低突变率可达到0.01%。通过综合采用野生型特异性封闭引物和突变富集扩增条件等方法证明了其0.01%的突变检测灵敏度。检测准确性优于现有商品化试剂盒,血浆DNA TB-ARMS qPCR检测结果与配对组织DNA测序结果相符合。因此,TB-ARMS kras基因突变检测方法具有广泛的临床应用价值,既适用于临床组织样品的检测,也可应用于液体活检。     

食品中沙门氏菌分子检测靶点的筛选与评价

[目的]发掘新的沙门氏菌分子检测靶点,筛选检测性能优秀的引物.[方法]利用BLAST程序比较沙门氏菌属内基因组DNA序列的同源性以及沙门氏菌与非沙门氏菌基因组DNA序列之间的特异性,发掘出100多个检测沙门氏菌属的特异性片段,并从中随机挑选出15个片段作为候选靶点,一共设计了27对引物(FS1～FS27),对它们的特异性、灵敏度加以评价,从中筛选检测性能最好的引物.[结果]在27对引物中,检测性能最优的引物为FS23,采用该引物对供试菌株的相应检测靶点进行PCR扩增,44株沙门氏菌都能扩增到一条492 bp特异性片段,而22株非沙门氏菌则不能扩增出这一特异性片段.以FS23为引物建立PCR方法检测猪霍乱沙门氏菌基因组DNA的灵敏度为11.9 fg/μL,细菌纯培养物灵敏度为4.9×102cfu/mL;用猪霍乱沙门氏菌人工污染牛奶样品,如果接种起始菌量为100 cfu/25 mL时,只需要增菌5 h,采用上述方法即能检测出沙门氏菌.[结论]引物FS23对应的基因序列是一个性能优良的新分子检测靶点,具备很高的特异性和灵敏性,能够广泛应用于食品中沙门氏菌的快速检测.     

O1群霍乱弧菌实时荧光定量PCR快速检测方法的建立

目的:建立针对O1群霍乱弧菌的实时荧光定量TaqMan PCR快速检测方法,并进行模拟粪便标本的检测评价。方法:根据O1群霍乱弧菌O抗原编码基因rfb的特异性序列设计引物和TaqMan探针,建立检测O1群霍乱弧菌的实时荧光定量TaqMan PCR快速检测方法,对所建立的方法分别进行实验室内的灵敏度及特异性评价;将O1群霍乱弧菌灭活菌株悬液倍比稀释后与健康成人新鲜粪便混匀,制备成模拟带菌者粪便标本,提取DNA,进行Taq-Man PCR检测,用以评价该方法。结果:建立了快速检测O1群霍乱弧菌的实时荧光定量TaqMan PCR方法,灵敏度为每反应体系104拷贝;该方法对其他14种肠道菌DNA没有扩增;该方法对模拟粪便标本的检测灵敏度为每反应体系102 CFU。结论:建立了一种快速、高效检测O1群霍乱弧菌的荧光定量PCR检测方法,该方法可用于O1群霍乱弧菌临床粪便标本的检测。     

轮状病毒NASBA检测研究

轮状病毒是世界范围内流行性胃肠炎暴发的重要病因。以患者粪便为样抽提轮状病毒RNA,在轮状病毒VP7高保守基因区段上设计引物,运用核酸序列依赖的扩增(NASBA)法进行检测,变性琼脂糖凝胶电泳和Northern杂交验证。NASBA预期的特异性产物为392bp,并在仅以目标核酸为模板或在浓度高达1μg/μL的非特异性核酸存在的混合模板中,均有清晰的目标带产生,表现出了很高的特异性。其灵敏度和RT-PCR相同甚至更高,可检测到50pg的核酸,并且当反应时间为3h时检测灵敏度最高。NASBA法扩增效率高、灵敏度高、快速易操作,尤其适用在基层单位推广应用。     

地高辛标记探针检测重组定点突变巴曲酶蛋白宿主DNA残留量的研究

目的 建立检测重组定点突变巴曲酶原液中外源性DNA残留量的方法.方法 从重组定点突变巴曲酶酵母工程菌提取基因组DNA作为模板,制备地高辛标记探针.此探针与样品进行点样杂交,并进行显色反应.结果 3批重组定点突变巴曲酶原液中,每人份剂量的宿主DNA残留量均＜10 ng.结论 该方法检测灵敏度较好,特异性较强,可用于重组定点突变巴曲酶的检测.     

温室白粉虱SCAR分子鉴定技术的建立及应用

温室白粉虱Trialeurodes vaporariorum是为害我国蔬菜作物的重大害虫之一。本研究采用随机扩增多态性DNA(Random Amplified Polymorphic DNA,RAPD)技术对温室白粉虱进行研究,筛选出一条620bp的特异性片段(GenBank登录号为JQ690764),据此片段的测序结果设计一对特异性的序列特异性扩增区(Sequence characterized Amplified Region,SCAR)标记(Tv-F和Tv-R),可成功从室内饲养的和从不同地区田间采集的温室白粉虱的基因组DNA中扩增出一条412bp的特异性条带,而不能从供试的其他粉虱类害虫中扩增出该相应条带。单头温室白粉虱成虫的基因组DNA稀释1000倍时,该SCAR标记仍可成功扩增出预期条带,显示出极高的灵敏度。该SCAR标记对温室白粉虱的基因组DNA扩增重复性和稳定性好,且操作简便,灵敏度高,可用于样品的大规模检测,为田间温室白粉虱的快速识别鉴定及其有效防治提供了技术基础。     

基于 LUX 引物的 HBV 实时 PCR检测方法的建立

实时PCR技术因其快速、准确、灵敏度和重复性高、可减少交叉污染等特点而广泛应用于分子生物学和医学研究领域。本研究建立了一种基于LUX （Light Upon eXtension）引物的HBV病毒载量检测的实时定量PCR检测方法。通过检测系列稀释的HBV DNA（5-5×108拷贝/反应）来验证LUX实时分析的性能和灵敏度。结果表明该检测方法在Ct值和log10 HBV DNA浓度之间存在很好的线形关系,并且具有很高的灵敏度,检测低限可达每毫升血清中50拷贝的HBV。对91份阳性血清样品的检测和熔解曲线分析表明该方法具有很高的特异性。新建立的LUX实时检测方法为检测治疗效果、研究HBV病毒载量和疾病发展之间的关系提供了一种理想的工具。     

结直肠癌无创筛查技术研究进展

结直肠癌和高危腺瘤的早期诊断及治疗,能够大大降低其死亡率。因而,在临床普及结直肠癌筛查有助于遏制该疾病的危害。目前,结肠镜检查是结直肠癌诊断的金标准,但该方法需要肠道准备,且具有侵入性,易造成肠道穿孔等缺点,导致患者依从性差,不利于其作为大规模筛查技术推广实施。近年来非侵入性的结直肠癌诊断方法发展迅速,这类方法主要通过检测粪便或血液样本中与结直肠癌发生相关的生物标志物,为结直肠癌的无创筛查提供了可能。但由于粪便、血液样本的成分复杂,对其中生物标志物的检测技术仍然在不断研究和完善中。本文分别从基于粪便样本和血液样本的检测技术两方面入手,探讨了近年来结直肠癌无创筛查技术的研究进展。     

Stool DNA test targeting methylated syndecan-2 (SDC2) as a noninvasive screening method for colorectal cancer

Despite the steadily increasing worldwide incidence of colorectal cancer (CRC), an effective noninvasive approach for early detection of CRC is still under investigation. The guaiac-based fecal occult blood test (FOBT) and fecal immunochemical test (FIT) have gained popularity as noninvasive CRC screening tests owing to their convenience and relatively low costs. However, the FOBT and FIT have limited sensitivity and specificity. To develop a noninvasive tool for the detection of CRC, we investigated the sensitivity, specificity, and accuracy of a stool DNA test targeting methylated syndecan-2 (SDC2), which is frequently methylated in patients with CRC. The present study enrolled 62 patients diagnosed as having stage 0-IV CRC and 76 healthy participants between July 2018 and June 2019 from two institutions. Approximately 4.5 g of stool sample was collected from each participant for detection of human methylated SDC2 gene. In total, 48 of 62 (77.4%) patients with CRC showed positive results, whereas 67 out of 76 (88.2%) healthy participants showed negative results. The area under the curve of the receiver operating characteristic curve constructed was 0.872 for discrimination between patients with CRC and healthy individuals. The present study highlights the potential of the fecal methylated SDC2 test as a noninvasive detection method for CRC screening with a relatively favorable sensitivity of 77.4%, a specificity of 88.2% and a positive predictive value of 84.2% compared with other available fecal tests. Further multicenter clinical trials comprising subjects of varied ethnicities are required to validate this test for the mass screening of patients with CRC.     

Predicting the progress of colon cancer by DNA methylation markers of the p16 gene in feces - Evidence from an animal model

A new noninvasive screening tool for colorectal neoplasia detects epigenetic alterations exhibited by gastrointestinal tumor cells shed into stool. There is insufficient existing data to determine temporal associations between colorectal cancer (CRC) progression and aberrant DNA methylation. To evaluate the feasibility of using fecal DNA methylation status to determine CRC progression, we collected stool samples from 14 male SD rats aged six weeks, and administered subcutaneous injections of either 1,2-dimethylhydrazine or saline weekly. p16 DNA methylation statuses in tumorous and normal colon tissue, and from stool samples were determined using methylation-specific PCR. Additionally, p16 methylation was detected in stool DNA from 85.7% of the CRC rats. The earliest change in p16 methylation status in the DMH-treated group stool samples occurred during week nine; repeatabilities were 57.1% in week 19 (p = 0.070) and 85.7% in week 34 (p = 0.005). A temporal correlation was evidenced between progression of CRC and p16 methylation status, as evidenced by DMH-induced rat feces. Using fecal DNA methylation status to determine colorectal tissue methylation status can reveal CRC progression. Our data suggests that p16 promoter methylation is a feasible epigenetic marker for the detection and may be useful for CRC screening.     

Detection of methylated tissue factor pathway inhibitor 2 and human long DNA in fecal samples of patients with colorectal cancer in China

Background: To investigate the feasibility of detecting methylated tissue factor pathway inhibitor (TFPI2) and quantifying human long DNA with fluorescent quantitative Alu PCR in fecal DNA as a non-invasive screening tool for colorectal cancer (CRC). Materials and Methods: Methylation-specific PCR (MSP) was performed to analyze TFPI2 gene promoter methylation status in a blinded fashion in stool samples taken from 30 endoscopically diagnosed healthy controls, 20 patients with adenomas, and 60 patients with colorectal cancer. Real-time Alu PCR was used to quantify human long DNA. Results: The specificity of fecal TFPI2 MSP assay and long DNA assay was 100% and 83.3%, respectively. The sensitivity of fecal TFPI2 MSP assay and long DNA assay was 68.3% and 53.3%, respectively. The sensitivity of fecal DNA assay (either marker being positive) was 86.7%, which was high for CRC. Conclusions: Our results have demonstrated the feasibility of using TFPI2 methylation and quantify human long DNA with fluorescent quantitative Alu PCR in fecal samples as a new noninvasive test for CRC.     

Use of RNA isolated from feces as a promising tool for the early detection of colorectal cancer

Colorectal cancer is one of the most common forms of cancer worldwide. Early detection would allow patients to be treated surgically and halt the progression of the disease; however, the current methods of early detection are invasive (colonoscopy and sigmoidoscopy) or have low sensitivity (fecal occult blood test). The altered expression of genes in stool samples of patients with colorectal cancer can be determined by RT-PCR. This is a noninvasive and highly sensitive technique for colorectal cancer screening. According to information gathered in this review and our own experience, the use of fecal RNA to determine early alterations in gene expression due to malignancy appears to be a promising alternative to the current detection methods and owing to its low cost could be implemented in public health services.     

A projection of benefits due to fecal occult blood test for colorectal cancer

Objectives: A prospective study to estimate benefits due to fecal occult blood tests for colorectal cancer are carried out for both males and females, under different screening frequencies. Methods: We apply the statistical method developed by Wu et al. (2007) [1] using the Minnesota colorectal cancer study group data, to make Bayesian inference for the lead time, the time of diagnosis advanced by screening for both male and female participants in a periodic screening program. The lead time is distributed as a mixture of a point mass at zero and a piecewise continuous distribution. The two parts of the mixture correspond to two aspects of the screening: the probability of no benefit, or the percentage of interval cases; and the probability distribution of the early diagnosis time. We present estimates of these two measures for males and females by simulation studies using the Minnesota study group data. We also provide the mean, mode, variance, and density curve of the program's lead time by gender. This may provide policy makers important information on the effectiveness of the FOBT screening in colorectal cancer early detection. Results: The mean lead time increases as the screening time interval decreases for both males and females. The standard error of the lead time also increases as the screening time interval decreases for both genders. Females seem get more benefit than males, in that females usually have a longer lead time than males if both take the test at the same time interval and the lead time mode for females is greater than that of males in the same screening time interval. Conclusion: According to the predictive estimation of the lead time distribution, to guarantee a 90% chance of early detection, it seems necessary for the males to take the fecal occult blood test every 9 months, while the females can take it annually.     

Colorectal adenoma and cancer detection based on altered methylation pattern of SFRP1, SFRP2, SDC2, and PRIMA1 in plasma samples

Aberrant methylation is one of the most frequent epigenetic alterations that can contribute to tumor formation. Cell-free DNA can originate from tumor tissue; therefore, the evaluation of methylation markers in cell-free DNA can be a promising method for cancer screening. Our aim was to develop a panel of biomarkers with altered methylation along the colorectal adenoma-carcinoma sequence in both colonic tissue and plasma. Methylation of selected CpG sites in healthy colonic (n = 15), adenoma (n = 15), and colorectal cancer (n = 15) tissues was analyzed by pyrosequencing. MethyLight PCR was applied to study the DNA methylation of SFRP1, SFRP2, SDC2, and PRIMA1 gene promoters in 121 plasma and 32 biopsy samples. The effect of altered promoter methylation on protein expression was examined by immunohistochemistry. Significantly higher (P < 0.05) DNA methylation levels were detected in the promoter regions of all 4 markers, both in CRC and adenoma tissues compared with healthy controls. Methylation of SFRP1, SFRP2, SDC2, and PRIMA1 promoter sequences was observed in 85.1%, 72.3%, 89.4%, and 80.9% of plasma samples from patients with CRC and 89.2%, 83.8%, 81.1% and 70.3% from adenoma patients, respectively. When applied as a panel, CRC patients could be distinguished from controls with 91.5% sensitivity and 97.3% specificity [area under the curve (AUC) = 0.978], while adenoma samples could be differentiated with 89.2% sensitivity and 86.5% specificity (AUC = 0.937). Immunohistochemical analysis indicated decreasing protein levels of all 4 markers along the colorectal adenoma-carcinoma sequence. Our findings suggest that this methylation biomarker panel allows non-invasive detection of colorectal adenoma and cancer from plasma samples.     

Evaluating the long-term effect of FOBT in colorectal cancer screening

BackgroundCancer screening has been effective in detecting tumors early before symptoms appear. However, the effectiveness of the regular fecal occult blood test (FOBT) in colorectal cancer in the long term has not been quantified.MethodsWe applied the statistical method developed by Wu and Rosner [1] using data from the Minnesota Colon Cancer Control Study (MCCCS). All initially asymptomatic participants were classified into four mutually exclusive groups: true-early-detection, no-early-detection, over-diagnosis, and symptom-free life; human lifetime was treated as a random variable and is subject to competing risks. All participants in the screening program will eventually fall into one of the four outcomes above. Predictive inferences on the percentages of the four outcomes for both genders were made using the Minnesota study data.ResultsDepending on gender, screening frequency and age at the initial screening, for all participants the probability of “symptom-free-life” varies between 95.3% and 96.6%; the probability of “true-early-detection” is 1.9–3.8%; the probability of no-early-detection is 0.3–2.0%; the probability of over-diagnosis is 0.16–0.3%. Among those with colorectal cancer detected by regular FOBT, the probability of over-diagnosis is lower than expected and is between 6% and 9%, with 95% CI (2.5%, 21.3%) for females and (1.9%, 44.7%) for males. The probability of true-early-detection increases as screening interval decreases. The probability of no-early-detection decreases as screening interval decreases.ConclusionThe probability of over-diagnosis among the screen-detected cases is not as high as previously thought. We hope this outcome can provide valuable information on the effectiveness of the FOBT in colorectal cancer detection in the long term.     

Early detection of colon cancer: new tests on the horizon

This year, the American Cancer Society reported that the rate of decline in both the incidence and mortality of colorectal cancer has increased over the last two decades. This success is felt to be attributable to the early detection and treatment of colonic adenomas and early-stage colorectal cancers. However, the current recommended 'menu of options' for screening is limited by poor patient acceptance, low sensitivity, and both high cost and poor accessibility for application to a large general screening population (colonoscopy). Computerized tomography and magnetic resonance colonography offer an alternative method for the identification of polyps and early lesions in certain patients, but have cost, access, and acceptance limitations that are similar to those of colonoscopy; thus, they present similar barriers to their use in broad population screening. These limitations provide a strong rationale for the development of early colorectal cancer detection biomarkers that are simple to use and are cost effective. A successful biomarker or biomarker panel, coupled with the colonoscopic follow-up of only those patients with positive results, would reduce the burden and morbidity associated with the screening of colonoscopy. This would most likely result in enhanced adherence to colorectal screening, as well as a dramatic reduction in the incidence and mortality rates of colorectal cancer. In this paper, we review recent advances in the discovery of potential colorectal cancer biomarkers. Their applicability to clinical population screening will require large prospective validation.     

Potential of fecal microbiota for early-stage detection of colorectal cancer

Several bacterial species have been implicated in the development of colorectal carcinoma (CRC), but CRC-associated changes of fecal microbiota and their potential for cancer screening remain to be explored. Here, we used metagenomic sequencing of fecal samples to identify taxonomic markers that distinguished CRC patients from tumor-free controls in a study population of 156 participants. Accuracy of metagenomic CRC detection was similar to the standard fecal occult blood test (FOBT) and when both approaches were combined, sensitivity improved > 45% relative to the FOBT, while maintaining its specificity. Accuracy of metagenomic CRC detection did not differ significantly between early- and late-stage cancer and could be validated in independent patient and control populations (N = 335) from different countries. CRC-associated changes in the fecal microbiome at least partially reflected microbial community composition at the tumor itself, indicating that observed gene pool differences may reveal tumor-related host–microbe interactions. Indeed, we deduced a metabolic shift from fiber degradation in controls to utilization of host carbohydrates and amino acids in CRC patients, accompanied by an increase of lipopolysaccharide metabolism.