Rb、MDM2和Bcl-2自身抗体联合检测在食管癌高发地区人群筛查中的应用  

Application of Combined Detection of Rb,MDM2 and Bcl-2 Autoantibodies in Population Screening in High Incidence Area of Esophageal Cancer

作　　者：赵学科[1] 马磊[2] 胡守佳[1] 程锟 王盼盼[1] 钟侃 胡景峰 宋昕[1] 王伟[1] 李欣然 杨苗苗[1] 徐瑞华 魏梦霞 韩文莉 雷玲玲 孟超龙 库建伟 任书伟 张冬云[5] 王立东[1] ZHAO Xue-ke;MA Lei;HU Shou-jia;CHENG Kun;WANG Pan-pan;ZHONG Kan;HU Jing-feng;SONG Xin;WANG Wei;LI Xin-ran;YANG Miao-miao;XU Rui-hua;WEI Meng-lu;HAN Wen-li;LEI Ling-ling;MENG Chao-long;KU Jian-wei;REN Shu-wei;ZHANG Dong-yun;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 Oncology,Nanyang First People's Hospital,Nanyang 453003;Department of Endoscopy,Third Affiliated Hospital of Nanyang Medical College,Nanyang 453003,China;Department of Cardiothoracic Surgery,Xinyang Central Hospital,Xinyang,464000,China;Department of Pathology,Nanyang Medical College,Nanyang 473058,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]南阳市第一人民医院肿瘤科,河南南阳453003 [3]南阳医学高等专科学校第三附属医院内镜室,河南南阳473058 [4]信阳市中心医院心胸外科,河南信阳464000 [5]南阳医学高等专科学校病理教研室,河南南阳473058

出　　处：《食管疾病》2020年第4期246-249,共4页Journal of Esophageal Diseases

基　　金：国家科技部863重大专项(2012AA02A503)。

摘　　要：目的探讨肿瘤相关抗原Rb、MDM2、Bcl-2自身抗体在食管癌高危人群预警和早期发现中的价值。方法用ELISA方法分别检测以上自身抗体在215例食管癌和215例正常人群血清中的差异;对589例食管癌高发区无症状人群行自身抗体液体活检、色素内镜和病理检查,比较该组指标对高危人群预警和早期发现的意义;对19986例无症状人群进行自身抗体检测,预测高危人群和早期癌。结果3种自身抗体联合检测(至少1个指标)阳性无症状人群患食管癌风险是阴性人群的25.69倍,敏感和特异度分别为84.65%和82.33%,远高于其他组合;589例无症状人群自身抗体检出125例高危人群、黏膜活检确诊食管癌和癌前病变51例,其中高危人群检出43例(84.31%),P<0.001;19986例无症状人群检出3624例高危人群(18.13%),该人群黏膜活检确诊早期食管癌455例(2.28%)、不典型增生1352例(6.76%)。结论Rb、MDM2、Bcl-2这3种自身抗体联合检测可作为食管癌高危人群预警和早期筛查的有效技术推广应用。Objective To investigate the value of tumor-associated antigens included autoantibodies in early warning and early detection of esophageal cancer in high-risk population.Methods ELISA was used to detect the difference of Rb,MDM2 and Bcl-2 autoantibodies in the serum of 215 cases of esophageal cancer and 215 cases of normal population.A total of589 asymptomatic patients with high incidence of esophageal cancer were examined by autoantibodies,chromoendoscopys and pathological examinationsto compared the significance of these indicators for early warning and early detection in high-risk population.Besides,autoantibodies were performed to predict high-risk and early cancer in 19986 asymptomatic patients.Results The risk of esophageal cancer was 25.69 times higher in asymptomatic people with positive three autoantibodies(at least one index),and the sensitivity and specificity were 84.65%and 82.33%respectively,which were much higher than other combinations.Among the 589 asymptomatic patients,125 high-risk patients were found by autoantibodies,and 51 cases of esophageal cancer and precancerous lesions were confirmed by mucosal biopsy,among which 43 cases of esophageal cancer and precancerous lesions(84.31%)were found at high risk,P<0.001.Among the 19986 asymptomatic patients,3624 high-risk patients(18.13%)were detected.455 cases of early esophageal cancer(2.28%)and 1352 cases of atypical hyperplasia(6.76%)were confirmed by mucosal biopsies.Conclusion Autoantibodies combined with Rb,MDM2 and Bcl-2 can be used as an important technique for early warning and early screening of high-risk population of esophageal cancer.

关 键 词：食管癌 自身抗体 高危人群预警 

分 类 号：R735.1[医药卫生—肿瘤]