肿瘤相关抗原与自身抗体检测对食管癌早期发现和高危人群预警的意义  

Clinical significance of tumor-associated antigens and autoantibody measurement in high-risk subject screening and early detection of esophageal cancer

作　　者：刘保池[1] 王立东[1] 杜芳[1] 冯常炜[2] 张延瑞[3] 刘宾[4] 杨孟选[1] 郭涛[1] 宋昕[1] 王苒[1] 何欣[1] 范宗民[1] 杜娴娟[1] 张建营[5] 张梅[1] 吴爱群[1] 

机构地区：[1]河南省食管癌重点开放实验室郑州大学基础医学院 [2]郑州大学第二附属医院消化内科,河南郑州450003 [3]河南省人民医院消化内科,河南郑州450003 [4]首都医科大学同仁医院消化内科,北京100730 [5]郑州大学公共卫生学院

出　　处：《中华肿瘤防治杂志》2007年第9期645-649,共5页Chinese Journal of Cancer Prevention and Treatment

基　　金：国家自然科学基金(30025016);国家科技部863重大项目(2007);河南省医学创新人才工程项目(200084)

摘　　要：目的:探讨检测食管癌相关抗原与自身抗体对食管癌早期发现和高危人群预警的意义。方法:应用间接酶联免疫反应法和肿瘤相关抗原微阵列(包含8个重组的癌抗原蛋白C-myc、p53、cyclinB1、p16、p62、Koc、Imp1和Survivin)检测河南食管癌高发区无症状居民血清自身抗体。根据自身抗体变化对部分居民进一步作食管内镜检查和黏膜活检及免疫组织化学检测,了解血清自身抗体阳性和阴性居民食管上皮组织病理学变化特征及组织中相应肿瘤相关抗原变化的关系。结果:391例无症状居民中,79例(20%)至少呈现1种自身抗体阳性。对64例自身抗体阳性组和67例自身抗体阴性组居民进行内镜检查和黏膜活检组织病理学检查,发现2例早期食管癌,且均在抗体阳性组。血清自身抗体阳性组食管癌前病变发生率明显高于自身抗体阴性组,P<0.01。阳性百分率随食管上皮病变加重呈现线性增高趋势。食管上皮组织中,8种肿瘤相关抗原表达与血清中相应自身抗体有明显相关性,P<0.05。结论:血清肿瘤相关自身抗体检测有助于提高食管癌高发区无症状居民食管癌前癌变和早期食管癌的检出率。血清自身抗体与食管上皮组织中相应肿瘤抗原的表达变化明显相关。血清肿瘤相关自身抗体检测结合黏膜活检可能是食管癌早期发现和高危人群预警的重要手段。OBJECTIVE：To determine the significance of the tumor-associated antigen and autoantibody measurement in high-risk subject screening and early detection for esophageal cancer. METHODS： The enzyme-linked immu noassay and tumor-associated antigen mini-array （consisting of eight full length recombinant proteins, including C myc, p53, cyclin B1, p62. p16, Koc, Imp1, Survivin） were applied to determine tbe serum level of the auto anti bodies of these antigens on 391 symptom-free subjects from high incidence areas for esophageal cancer in Henan Prov ince. Endoscopic biopsies and histopathological examination were performed based on autoantibody measurement, Immunohistochemistry was performed to correlate the expression of tumor-associated antigens in esophageal epithelia with the corresponding serum auto-antibodies. RESULTS： Of the 391 symptom free subjects, 79（20%） were oh served with at least one kind of positive serum auto antibodies. Endoscopic and histopathological examination on 64 cases with positive serum auto-antihodies and 67 cases with negative serum auto-antibodies showed that two cases with early esophageal cancer were identified in autoantibody positive group, the detection rate of esophageal precancerous lesions in autoantibody positive group was higher than that in negative group, P〈0.05, and the positive percent of serum auto-antibodies increased with the mild to severe progression of the esophageal epithelial lesions. Furthermore, expressions of the total 8 tumor-associated antigens in esophageal tissue were correlated very well with the autoallti body measurement in serum. CONCLUSIONS： Measurement of tumor-associated auto-antibodies in serum may con tribute to the higher detection rate of esophageal precancerous lesions and early esophageal cancer. Serum level of auto antibodies is correlated well with the expression of corresponding tumor associated antigens in esophageal epithelia tissue. Autoantibody measurement together with the endoscopic biopsy may be one of tbe key strategies

关 键 词：食管肿瘤/流行病学 癌前状态 抗原 肿瘤 自身抗体 多相筛查 

分 类 号：R735.1[医药卫生—肿瘤]