自身抗体联合检测在食管癌早期筛查中的意义和应用  

Significance and Application of Combined Detection of Esophageal Cancer Autoantibody in Early Screening

作　　者：王伟[1,2] 李爱丽[3] 宋昕[1] 李欣然[1] 杨苗苗 徐瑞华[1] 魏梦霞 韩文莉 雷玲玲 赵学科 孟超龙[1] 胡守佳 程锟[1,2] 王盼盼 钟侃[1] 胡景峰 郭贵周 王立东 WANG Wei;LI Ai-li;SONG Xin;LI Xin-ran;YANG Miao-miao;XU Rui-hua;WEI Meng-xia;HAN Wen-li;LEI Ling-ling;ZHAO Xue-ke;MENG Chao-long;HU Shou-jia;CHENG Kun;WANG Pan-pan;ZHONG Kan;HU Jing-feng;GUO Gui-zhou;WANG Li-dong(State Key Laboratory of Esophageal Cancer Prevention&Treatment and Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052,China;Department of Pathology and Pathophysiology,School of Basic Medicine Science,Zhengzhou University,Zhengzhou 450051,China;Department of Oncology,Linzhou Cancer Hospital,Linzhou 456550,China;Institute of Cancer Prevention and Treatment,Linzhou Cancer Hospital,Linzhou 456550,China)

机构地区：[1]郑州大学第一附属医院省部共建食管癌防治国家重点实验室,河南郑州450052 [2]郑州大学基础医学院病理学与病理生理学教研室,河南郑州450052 [3]林州市肿瘤医院肿瘤内科,河南林州456550 [4]林州市肿瘤医院肿瘤防治研究所,河南林州456550

出　　处：《食管疾病》2020年第4期241-245,共5页Journal of Esophageal Diseases

基　　金：国家科技部863重大专项(2012AA02A503)。

摘　　要：目的建立食管鳞癌(ESCC)早期筛查的血清学指标方法,评价其在无症状人群中的应用价值。方法用酶联免疫法比较血清中4种自身抗体(cyclinB1、TGF-β1、Bcl-2、BRCA2)在ESCC患者和正常人群表达的差异,确立最佳检测指标组合;对食管癌高发区1350例无症状个体进行血清学检测,结合内镜病理活检对比指标检测结果差异;在林州高发区进行大规模无症状人群血清学检测,对阳性组行内镜病理活检,预测ESCC检出情况。结果4种自身抗体在350例ESCC和350例正常人群中表达存在明显差异(P<0.001),当4种指标联合检测时判定效能最好(灵敏度82.00%,特异性79.71%);对高发区1350例无症状人群进行血清学检测结合内镜病理活检,在阳性组中检出34例ESCC;阴性组中检出1例ESCC;对20153例高发区无症状人群行血清学检测,共检出3855例高危个体(19.13%),内镜检出517例早期癌。结论cyclinB1、TGF-β1、Bcl-2和BRCA2联合检测提高了早期癌的检出率,节约了成本,是食管癌高危人群预警和早期癌筛查值得推广的有效方法。Objective To establish a serological index method for early screening of esophageal squamous cell carcinoma(ESCC)and evaluate its application value in asymptomatic people.Methods Enzyme-linked immunoassay(ELISA)was used to detected and compared the expression differences of autoantibodies(cyclinB1,TGF-1,Bcl-2 and BRCA2)in the sera of ESCC patients and the normal population to determine the optimal combination of detection indicators.Serological tests were performed on 1350 asymptomatic patients in areas with high incidence of esophageal cancer,and the results were different in combination with the contrast indicators of endoscopic pathological biopsy.A large-scale asymptomatic population serological test was carried out in the high-incidence area of Linzhou,and endoscopic pathological biopsy was performed on the positive group to predict the detection of ESCC.Results There are significant differences in the expression of 4 autoantibody indexes in 350 ESCC and 350 normal populations(P<0.001).When the 4 indexes are tested in combination,the judgment efficiency is the best(sensitivity82.00%,specificity 79.71%).Serological tests combined with endoscopic pathological biopsy were performed on 1350 asymptomatic patients in the high-risk area,and 34 cases of ESCC were detected in the positive group and 1 case in the negative group.Serological testing of 20153 cases of asymptomatic people in highrisk areas detected a total of 3855 high-risk subjects(19%),and endoscopic detection of 517 cases of early cancer accounted for 95%.Conclusion Combined detection of cyclinB1,TGF-1,Bcl-2 and BRCA2 improves the detection rate of early cancer and saves costs,and is an effective method worthy of promotion for early warning and early cancer screening of high-risk population of esophageal cancer.

关 键 词：食管癌 早期筛查 自身抗体 肿瘤相关抗原 液体活检 

分 类 号：R735.1[医药卫生—肿瘤]