六种肿瘤相关抗原自身抗体联合CA125检测对卵巢癌早期诊断的价值  

Evaluation of detecting autoantibodies against six tumor-associated antigens with CA125 in early diagnosis of ovarian cancer

作　　者：李留霞[1] 张兰兰[1] 李秀芳[1] 张建营[2,3] 王凯娟[2,3] 代丽萍[2,3] 王鹏[2,3] 张毅[4,5] 

机构地区：[1]郑州大学第一附属医院妇产科,郑州450052 [2]郑州大学公共卫生学院 [3]郑州大学蛋白质组学应用研究中心,郑州450001 [4]郑州大学第一附属医院生物细胞治疗中心 [5]郑州大学生物工程系,郑州450052

出　　处：《郑州大学学报（医学版）》2013年第2期238-242,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家自然科学基金资助项目81172086

摘　　要：目的:探讨肿瘤相关抗原(TAAs)P53、Survivin、IMP1、CyclinD1、C-myc及CyclinE自身抗体联合CA125检测对卵巢癌早期诊断的价值。方法:应用间接ELISA法检测78例原发性上皮性卵巢癌、60例卵巢良性肿瘤、100例正常对照血清中以上6种TAAs抗体,电化学发光法测定血清CA125含量。结果:卵巢癌患者血清中TAAs抗体的阳性率高于正常对照组(P均<0.05),每种TAA单独检测的阳性率为11.5%～35.9%;对6种TAAs抗体进行组合,随着联合抗体数目的增加,检测阳性率随之增加,6种TAAs抗体联合检测的阳性率为55.1%;6种TAAs抗体联合CA125检测卵巢癌的灵敏度为96.2%,特异度为76.0%,阳性预测值为75.8%,阴性预测值为96.2%,阳性似然比为6.25,阴性似然比为0.14;6种TAAs抗体联合CA125检测早期卵巢癌的阳性率为89.3%,明显高于单独应用CA125的检测阳性率(χ2=4.909,P=0.027)。结论:利用6种TAAs抗体组合检测卵巢癌具有较高的真实性,可能为卵巢癌诊断提供一定的参考价值;6种TAAs抗体联合CA125检测可明显提高卵巢癌的检测灵敏度,特别是对早期卵巢癌的检测可能具有重要价值。Aim： To evaluate the value of P53,Survivin,IMP1,Cyclin D1,C-myc,and Cyclin E with CA 125 in the early diagnosis of ovarian cancer. Methods： Autoantibodies against six tumor-associated antigen（ TAAs） in sera from 78 patients with primary epithelial ovarian cancer,60 patients with benign ovarian tumor and 100 healthy controls were analyzed using enzyme-linked immunosorbent assay. The levels of CA125 in sera were then examined by electrochemiluminescence method. Results： The levels of antibody against P53,Survivin,IMP1,Cyclin D1,C-myc and Cyclin E were significantly higher in all of the ovarian cancer patients than normal controls. The sensitivity of individual TAA antibody was from 11. 5% in Cyclin E to 35. 9% in P53. However,with the successive addition of TAAs to a final total of six antigens,there was a stepwise increase in positivity which reached up to 55. 1% . When detecting antibodies against six TAAs and CA125 together,the sensitivity reached up to 96. 2% . Specificity,positive predictive value,negative predictive value,positive likelihood ratio and negative likelihood ratio were 76. 0% ,75. 8% ,96. 2% ,6. 25 and 0. 14,respectively. In early ovarian cancer patients,the sensitivity of detection of antibodies against six TAAs with CA125 together was about 89. 3% ,which was obviously higher than using CA125 alone （ χ2 = 4. 909,P = 0. 027） . Conclusion： The detection of antibodies against a mini-array of six TAAs namely P53,Survivin,IMP1,CyclinD1,C-myc,and Cyclin E in combination with CA125 could in-crease the sensitivity of detecting ovarian cancer. And this may be an important reference value for diagnosis of ovarian cancer especially early stages of the disease.

关 键 词：卵巢癌 肿瘤相关抗原 自身抗体 CA125 评价 

分 类 号：R737.31[医药卫生—肿瘤]