鼻咽癌患者四种血清自身抗体诊断价值的研究  

Diagnostic value of 4 kinds of serum autoantibodies in nasopharyngeal carcinoma

作　　者：易斌[1] 周欢群[1] 姚润[1] 肖志强[2] 

机构地区：[1]中南大学湘雅医院检验科,长沙410006 [2]中南大学湘雅医院卫生部肿瘤蛋白质组学重点实验室,长沙410006

出　　处：《中华检验医学杂志》2010年第8期747-751,共5页Chinese Journal of Laboratory Medicine

基　　金：国家重点基础研究发展规划项目（＂973计划＂）（2001CB5120）;湖南省＂芙蓉学者＂特聘教授科学研究基金（湘教通[2007]362号）;教育部跨世纪优秀人才培养计划基金（教计函[2002]48）;湖南省科技厅重点项目（06SK2004）; 志谢中南大学公共卫生学院流行病与卫生统计学系罗建清为本研究数据统计处理给予了大力支持

摘　　要：目的 以血清蛋白质组学方法筛选到的4种鼻咽癌患者自身抗体（Rho-GDI-2、HSP70、CK19和LAP3）为对象,分析其诊断鼻咽癌的价值.方法 通过对封闭条件、抗原浓度及血清稀释度等条件进行优化,建立鼻咽癌患者血清自身抗体的ELISA检测方法,采用该方法分别检测Rho-GDI-2、HSP70、CK19和LAP3自身抗体在36例鼻咽癌患者、20例其他肿瘤患者及20名健康人血清中的浓度,采用统计学方法分析其判别鼻咽癌的敏感度和特异度.结果 鼻咽癌患者血清中4种抗体的含量明显高于健康人（鼻咽癌患者CK19、Rho-GDI-2、HSP70、LAP3的A450值分别为0.188 8±0.047 3、0.240 5±0.024 7、0.116 8±0.025 3、0.2769±0.0442;健康人A450值分别为0.010 5±0.0044、0.1053±0.016 9、0.098 6±0.014 0、0.149 8±0.033 1;F值分别为4.869、15.919、10.331、6.369;P值分别为0.010、0.000、0.000、0.003）.Rho-GDI-2、HSP70、CK19和LAP3抗体判别鼻咽癌的敏感度分别为85.0%、75.0%、75.0%和75.0%,特异度分别为58.9%、80.4%、58.9%和57.1%准确性分别为76.8%、76.8%、69.6%和67.9%.以单个自身抗体作为判别鼻咽癌的指标,Rho-GDI-2抗体具有更高的敏感度,而HSP70抗体的特异度最高.4种抗体联合应用,判别鼻咽癌的敏感度和特异度可达94.4%和95.0%.结论 采用ELISA方法检测Rho-GDI-2、HSP70、CK19和LAP3自身抗体有助于鼻咽癌的筛杳和诊断.Objective To analyze the diagnostic value of 4 serum autoantibodies in nasopharyngeal carcinoma patients （anti-Rho-GDI-2, -HSP70, -CK19 and -LAP3 antibodies） using a serological proteomic approach. Methods The conditions for blocking, antigen concentrations and serum dilution were optimized to establish the ELISA method for detection of serum autoantibodies for Rho-GDI-2, HSP70, CK19 and LAP3. The serum concentrations of these autoantibodies were detected by the established method in 36 NPC patients, 20 other cancer patients and 20 healthy individuals. The statistical analysis was used to evaluate the diagnostic value of the 4 serum autoantibodies. Results The concentrations of 4 serum autoantibodies in the NPC patients were significantly higher than those in the healthy individuals（A450 values in NPC group of CK19, Rho-GDI-2, HSP70, LAP3 were 0. 188 8 ±0.047 3, 0.240 5 ± 0.024 7, 0. 116 8 ±0.025 3, 0.276 9 ±0.044 2 repectively. A450 values in healthy control group were 0.010 5 ±0.004 4, 0. 105 3 ±0. 016 9, 0. 098 6 ± 0. 014 0, 0. 149 8 ± 0. 033 1 respectively. F values were 4. 869, 15. 919, 10. 331,6. 369, respectively. P values were 0. 010, 0. 000, 0. 000, 0. 003, respectively）. The sensitivities of antiRho-GDI-2, anti-HSP70, anti -CK19 and anti -LAP3 autoantibodies for diagnosis of NPC was 85.0%,75.0%, 75.0% and 75.0%, respectively, and the specificities were 58.9%, 80. 4%, 58. 9% and 57. 1%, respectively, anti-Rho-GDI-2 and anti-HSP70 achived the highest sensitivity and specificity respectively when single marker was analyzed. The sensitivity and specificity were 94. 4% and 95. 0%respectively when 4 markers was combined for analysis. Conclusion Detection of serum anti-Rbo-GDI-2,anti-HSP70, anti-CK19 and anti-IAP3 auotantibedios by ELISA may be of help in the screening and diagnosis for NPC.

关 键 词：鼻咽癌 ELISA 自身抗体 诊断 标志物 

分 类 号：R739.63[医药卫生—肿瘤]