Diagnostic Value Of Combined Detection Of SHOX2 And RASSF1A Gene Methylation In Early Lung Cancer

Objective:The methylation status of SHOX2 and RASSF1 A in bronchoscopic bronchoalveolar lavage fluid(BALF)and CT-guided lung biopsy fluid of suspected early lung cancer patients with solitary pulmonary nodules(<3cm)and ground glass nodules was detected by chest imaging examination,so as to evaluate the clinical value of screening for early lung cancer.method:A prospective study was conducted in the Second Hospital of Jilin University from August 2019 to October 2020.Through chest imaging examination,SHOX2 and RASSF1 A methylation and pathological data of BALF or CT-guided lung biopsy fluid samples from patients with suspected early lung cancer with solitary pulmonary nodules <3cm and ground glass nodules were found,so as to evaluate the diagnostic efficacy of early lung cancer.SPSS 25.0 software was used for statistical analysis.Results:This study included 45 patients.There were 32 males and 13 females,aged from 19 to 80 years.There was no significant difference in gender and age between the two groups(p>0.05).Forty-five patients were pathologically diagnosed as pulmonary malignant tumors in 28 cases and benign pulmonary lesions in 17 cases.A total of 45 samples were collected.The sensitivity of SHOX2 and RASSF1 A arbitrary positive to the diagnosis of early lung cancer was 82.1%(23/28),and the specificity was82.4%(14/17).In lung cancer group,SHOX2 and RASSF1 A single positive,double positive and arbitrary positive rate was 78.6%,64.3%,60.7% and82.1%,far higher than the control group 11.8%,17.6%,11.8% and 17.6%,p<0.05,the difference was statistically significant.The methylation rate of SHOX2 was 100.0%(8/8),81.8%(9/11),50.0%(4/8)and 100%(1/1)in SCLC,lung squamous cell carcinoma,lung adenocarcinoma and unclear tissue type lung cancer,respectively.The methylation rates of RASSF1 A were 100.0%(8/8),63.6%(7/11),37.5%(3/8)and 0 in SCLC,lung squamous cell carcinoma,lung adenocarcinoma and lung cancer with unclear tissue types,respectively.Compared with cytological detection,the sensitivity of SHOX2 and RASSF1 A methylation in the detection of early lung cancer was78.6% and 64.3%,respectively,which were significantly higher than those of cytological detection(0%),and the specificity decreased from 100%to 88.2% and 82.4%,respectively.The sensitivity of combined detection for early lung cancer was significantly increased from 0% to 82.1%,but the specificity decreased to 82.4%.In the lung cancer group,there were0 cases of cancer cells detected by cytology.In the atypical cell group,13 cases of atypical cells were detected by cytology,and the double positive rate of SHOX2 and RASSF1 A gene methylation was 76.9%(10/13),and the arbitrary positive rate was 92.3%(12/13).In the cell negative group,the double positive rate of methylation was 60.0%(9/15),and the arbitrary positive rate was 93.3%(14/15).In this study,a total of 45 samples including 18 BALF samples were collected.Among them,the differential sensitivity of any positive expression of SHOX2 and RASSF1 A detected by RT-PCR was 75.0%(6/8),and the specificity was 90%(9/10).In lung cancer group,SHOX2 and RASSF1 A methylation single positive,double positive and arbitrary positive rates were 75.0%,62.5%,62.5% and 75.0%,much higher than 0,10%,0% and 10% in the control group,p<0.05,the difference was statistically significant.A total of 45 samples were collected in this study,including 27 samples of lung biopsy fluid guided by CT.Among them,the differential sensitivity of any positive expression of SHOX2 and RASSF1 A detected by RT-PCR was 85%(17/20),and the specificity was71.4%(5/7).In the lung cancer group,the arbitrary positive rates of SHOX2 and RASSF1 A methylation were 85.0%,which were much higher than those in the control group(28.6%),and the difference was statistically significant(p<0.05).Conclusion:1.For the diagnosis of early lung cancer,SHOX2 and RASSF1 A gene methylation arbitrary positive in BALF and biopsy fluid has good diagnostic efficiency.The combined detection of the two is expected to become a new screening indicator of molecular biology for clinical application.2.The combined detection of SHOX2 and RASSF1 A gene methylation for early lung cancer has higher diagnostic in early lung cancer,especially when the cytological test results are not clear or negative,it can be used as a supplement to cytological detection.