The value of plasma methylated Septin9 in monitoring the recurrence and metastasis of colorectal cancer after surgery_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHAO Tuanjie ¹ , SU Yue ¹ , ZHANG Zhiliang ¹ , REN Chuncheng ¹ , LIU Liancheng ¹ , QI Shunli ² , CHEN Xilin ² ,  ZHANG Yuru ¹

1. Department of Colorectal Surgery, Beijing Anorectal Hospital (Beijing Erlonglu Hospital), Beijing 100120, P. R. China;
2. Department of Pathology, Beijing Anorectal Hospital (Beijing Erlonglu Hospital), Beijing 100120, P. R. China;

Corresponding author：

ZHANG Yuru, Email: zhyr_11@163.com

Keywords：

colorectal cancer; methylated Septin9; postoperative surveillance; recurrence; metastasis

DOI：

10.7507/1007-9424.202108093

Video：

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Objective To evaluate the value of methylated Septin9 (mSEPT9) in the diagnosis and postoperative recurrence/metastasis monitoring of colorectal cancer. Methods A total of 76 patients with colorectal cancer who were hospitalized in Beijing Anorectal Hospital (Beijing Erlonglu Hospital) and positive for mSEPT9 before operation from January to December in 2020 were collected. Nineteen patients who were still positive for mSEPT9 at one week after operation were selected as the msept9 positive group, and 57 patients whose mSEPT9 became negative were selected as the msept9 negative group. The clinicopathological features and postoperative recurrence and metastasis of the two groups were analyzed and compared. Results There were significant differences in lymph node metastasis rate, vascular or nerve infiltration and clinical staging between the mSEPT9 positive group and the mSEPT9 negative group (P=0.024, P=0.009, P=0.009). There was no significant difference in age, gender, tumor location, degree of tumor differentiation, and tumor invasion depth (T stage), P>0.05. Two patients in the mSEPT9 positive group had liver metastases after operation, and there were no cases of metastasis or recurrence in the mSEPT9 negative group (P=0.024). Conclusion The mSEPT9 can be used as a potential tumor marker for the diagnosis of colorectal cancer and the monitoring of postoperative treatment effect, and more attention should be paid to patients who are still positive for mSEPT9 after surgery.

Citation： ZHAO Tuanjie, SU Yue, ZHANG Zhiliang, REN Chuncheng, LIU Liancheng, QI Shunli, CHEN Xilin, ZHANG Yuru. The value of plasma methylated Septin9 in monitoring the recurrence and metastasis of colorectal cancer after surgery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(6): 743-747. doi: 10.7507/1007-9424.202108093 Copy

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2.	van der Stok EP, Spaander M, Grünhagen DJ, et al. Surveillance after curative treatment for colorectal cancer. Nat Rev Clin Oncol, 2017, 14(5): 297-315.
3.	Rockall TA, McDonald PJ. Carcinoembryonic antigen: its value in the follow-up of patients with colorectal cancer. Int J Colorectal Dis, 1999, 14(1): 73-77.
4.	余智操, 吴晋, 张琼, 等. SEPT 9基因与恶性肿瘤关系的研究进展. 现代肿瘤医学. 2018. 26(2): 297-301.
5.	Tham C, Chew M, Soong R, et al. Postoperative serum methylation levels of TAC1 and SEPT9 are independent predictors of recurrence and survival of patients with colorectal cancer. Cancer, 2014, 120(20): 3131-3141.
6.	Su XL, Wang YF, Li SJ, et al. High methylation of the SEPT9 gene in Chinese colorectal cancer patients. Genet Mol Res, 2014, 13(2): 2513-2520.
7.	Church TR, Wandell M, Lofton-Day C, et al. Prospective evaluation of methylated SEPT9 in plasma for detection of asymptomatic colorectal cancer. Gut, 2014, 63(2): 317-325.
8.	Jin P, Kang Q, Wang X, et al. Performance of a second-generation methylated SEPT9 test in detecting colorectal neoplasm. J Gastroenterol Hepatol, 2015, 30(5): 830-833.
9.	Wu D, Zhou G, Jin P, et al. Detection of colorectal cancer using a simplified SEPT9 gene methylation assay is a reliable method for opportunistic screening. J Mol Diagn, 2016, 18(4): 535-545.
10.	郑民华, 冯波, 马君俊, 等. 腹腔镜结直肠癌根治术操作指南(2018版). 中华消化外科杂志, 2018, 17(9): 877-885.
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12.	赵媛, 陈四明, 蒋益兰, 等. Septin-9基因甲基化检测对结直肠癌诊断价值的meta分析. 中国医师杂志, 2020, 22(6): 852-856.
13.	Fu B, Yan P, Zhang S, et al. Cell-free circulating methylated SEPT9 for noninvasive diagnosis and monitoring of colorectal cancer. Dis Markers. 2018, 2018: 6437104. doi: doi: 10.1155/2018/6437104.
14.	Yang X, Xu ZJ, Chen X, et al. Clinical value of preoperative methylated septin 9 in Chinese colorectal cancer patients. World J Gastroenterol, 2019, 25(17): 2099-2109.
15.	Molnár B, Tóth K, Barták BK, et al. Plasma methylated septin 9: a colorectal cancer screening marker. Expert Rev Mol Diagn, 2015, 15(2): 171-184.
16.	Xie L, Jiang X, Li Q, et al. Diagnostic value of methylated Septin9 for colorectal cancer detection. Front Oncol, 2018, 8: 247. doi: 10.3389/fonc.2018.00247.
17.	Chen Y, Wang Z, Zhao G, et al. Performance of a novel blood-based early colorectal cancer screening assay in remaining serum after the blood biochemical test. Dis Markers, 2019, 2019: 5232780. doi: doi: 10.1155/2019/5232780.
18.	康倩, 金鹏, 杨浪, 等. 外周血游离DNA中Septin9基因甲基化在结直肠癌筛查中的意义. 中华医学杂志, 2014, 94(48): 3839-3841.
19.	李士杰, 刘艳刚, 王警, 等. 外周血Septin9基因甲基化检测在结直肠癌筛查中的应用. 中国普通外科杂志, 2015, 24(12): 1756-1760.
20.	吴东, 杨红, 李玥, 等. 外周血甲基化Septin9基因联合粪便免疫化学试验对专科门诊患者结直肠癌和腺瘤的筛查. 中华消化杂志, 2016, 36(2): 107-112.
21.	堵一乔, 胡婷婷, 王文惠, 等. 结直肠癌患者血浆SEPT9基因甲基化检测的研究. 中华检验医学杂志, 2018, 41(5): 395-398.
22.	Hu J, Hu B, Gui YC, et al. Diagnostic value and clinical significance of methylated SEPT9 for colorectal cancer: a meta-analysis. Med Sci Monit, 2019, 25: 5813-5822.
23.	Ma ZY, Law WL, Ng EKO, et al. Methylated Septin 9 and carcinoembryonic antigen for serological diagnosis and monitoring of patients with colorectal cancer after surgery. Sci Rep, 2019, 9(1): 10326. doi: 10.1038/s41598-019-46876-4.
24.	Song L, Guo S, Wang J, et al. The blood mSEPT9 is capable of assessing the surgical therapeutic effect and the prognosis of colorectal cancer. Biomark Med, 2018, 12(9): 961-973.
25.	祝志强. 血浆Septin9基因甲基化对结直肠癌诊断、手术疗效评估及复发监测的临床应用价值, 新疆医科大学, 2020.

1. 中华人民共和国卫生和计划生育委员会医政医管局, 中华医学会肿瘤学分会. 中国结直肠癌诊疗规范(2017年版). 中华外科杂志, 2018, 56(4): 241-258.
2. van der Stok EP, Spaander M, Grünhagen DJ, et al. Surveillance after curative treatment for colorectal cancer. Nat Rev Clin Oncol, 2017, 14(5): 297-315.
3. Rockall TA, McDonald PJ. Carcinoembryonic antigen: its value in the follow-up of patients with colorectal cancer. Int J Colorectal Dis, 1999, 14(1): 73-77.
4. 余智操, 吴晋, 张琼, 等. SEPT 9基因与恶性肿瘤关系的研究进展. 现代肿瘤医学. 2018. 26(2): 297-301.
5. Tham C, Chew M, Soong R, et al. Postoperative serum methylation levels of TAC1 and SEPT9 are independent predictors of recurrence and survival of patients with colorectal cancer. Cancer, 2014, 120(20): 3131-3141.
6. Su XL, Wang YF, Li SJ, et al. High methylation of the SEPT9 gene in Chinese colorectal cancer patients. Genet Mol Res, 2014, 13(2): 2513-2520.
7. Church TR, Wandell M, Lofton-Day C, et al. Prospective evaluation of methylated SEPT9 in plasma for detection of asymptomatic colorectal cancer. Gut, 2014, 63(2): 317-325.
8. Jin P, Kang Q, Wang X, et al. Performance of a second-generation methylated SEPT9 test in detecting colorectal neoplasm. J Gastroenterol Hepatol, 2015, 30(5): 830-833.
9. Wu D, Zhou G, Jin P, et al. Detection of colorectal cancer using a simplified SEPT9 gene methylation assay is a reliable method for opportunistic screening. J Mol Diagn, 2016, 18(4): 535-545.
10. 郑民华, 冯波, 马君俊, 等. 腹腔镜结直肠癌根治术操作指南(2018版). 中华消化外科杂志, 2018, 17(9): 877-885.
11. Benson AB, Venook AP, Al-Hawary MM, et al. NCCN Guidelines Insights: Rectal Cancer, Version 6. 2020. J Natl Compr Canc Netw, 2020, 18(7): 806-815.
12. 赵媛, 陈四明, 蒋益兰, 等. Septin-9基因甲基化检测对结直肠癌诊断价值的meta分析. 中国医师杂志, 2020, 22(6): 852-856.
13. Fu B, Yan P, Zhang S, et al. Cell-free circulating methylated SEPT9 for noninvasive diagnosis and monitoring of colorectal cancer. Dis Markers. 2018, 2018: 6437104. doi: doi: 10.1155/2018/6437104.
14. Yang X, Xu ZJ, Chen X, et al. Clinical value of preoperative methylated septin 9 in Chinese colorectal cancer patients. World J Gastroenterol, 2019, 25(17): 2099-2109.
15. Molnár B, Tóth K, Barták BK, et al. Plasma methylated septin 9: a colorectal cancer screening marker. Expert Rev Mol Diagn, 2015, 15(2): 171-184.
16. Xie L, Jiang X, Li Q, et al. Diagnostic value of methylated Septin9 for colorectal cancer detection. Front Oncol, 2018, 8: 247. doi: 10.3389/fonc.2018.00247.
17. Chen Y, Wang Z, Zhao G, et al. Performance of a novel blood-based early colorectal cancer screening assay in remaining serum after the blood biochemical test. Dis Markers, 2019, 2019: 5232780. doi: doi: 10.1155/2019/5232780.
18. 康倩, 金鹏, 杨浪, 等. 外周血游离DNA中Septin9基因甲基化在结直肠癌筛查中的意义. 中华医学杂志, 2014, 94(48): 3839-3841.
19. 李士杰, 刘艳刚, 王警, 等. 外周血Septin9基因甲基化检测在结直肠癌筛查中的应用. 中国普通外科杂志, 2015, 24(12): 1756-1760.
20. 吴东, 杨红, 李玥, 等. 外周血甲基化Septin9基因联合粪便免疫化学试验对专科门诊患者结直肠癌和腺瘤的筛查. 中华消化杂志, 2016, 36(2): 107-112.
21. 堵一乔, 胡婷婷, 王文惠, 等. 结直肠癌患者血浆SEPT9基因甲基化检测的研究. 中华检验医学杂志, 2018, 41(5): 395-398.
22. Hu J, Hu B, Gui YC, et al. Diagnostic value and clinical significance of methylated SEPT9 for colorectal cancer: a meta-analysis. Med Sci Monit, 2019, 25: 5813-5822.
23. Ma ZY, Law WL, Ng EKO, et al. Methylated Septin 9 and carcinoembryonic antigen for serological diagnosis and monitoring of patients with colorectal cancer after surgery. Sci Rep, 2019, 9(1): 10326. doi: 10.1038/s41598-019-46876-4.
24. Song L, Guo S, Wang J, et al. The blood mSEPT9 is capable of assessing the surgical therapeutic effect and the prognosis of colorectal cancer. Biomark Med, 2018, 12(9): 961-973.
25. 祝志强. 血浆Septin9基因甲基化对结直肠癌诊断、手术疗效评估及复发监测的临床应用价值, 新疆医科大学, 2020.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The value of plasma methylated Septin9 in monitoring the recurrence and metastasis of colorectal cancer after surgery

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