STK15、P15和MLH1肿瘤相关抗原自身抗体液体活检用于食管癌高危人群筛查研究  

Application of STK15,P15 and MLH1 Tumor Associated Antigen Autoantibodies Liquid Biopsy in Screening High Risk Subject of Esophageal Cancer

作　　者：胡景峰 宋昕[1] 高社干[2] 王伟[1,3] 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[1,3] 王盼盼 钟侃[1] 孔国强 王立东[1] HU Jing-feng;SONG Xin;GAO She-gan;WANG Wei;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;KONG Guo-qiang;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;The First Affiliated Hospital of Henan University of Science and Technology,Henan Key Laboratory of Cancer Epigenetics,Luoyang 471003,China;Department of Pathology and Pathophysiology,School of Basic Medicine Science,Zhengzhou University,Zhengzhou 450051,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]河南科技大学第一附属医院河南省肿瘤表观遗传学重点实验室,河南洛阳471003 [3]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450001

出　　处：《食管疾病》2020年第4期250-254,共5页Journal of Esophageal Diseases

基　　金：国家科技部863重大专项(2012AA02A503)。

摘　　要：目的探讨液体活检技术在食管癌高危人群预警和早期发现中的应用价值。方法利用间接酶联免疫法检测食管癌组和正常组肿瘤相关抗原自身抗体(STK15、P15、MLH1)的表达;在食管癌高发区对无症状人群行血清学和色素内镜联合检测;在食管癌高发区行大规模无症状人群筛查,并对血清学检查阳性者行色素内镜检查。结果3种自身抗体联合检测,食管癌患者血清自身抗体阳性率较正常人升高了6倍(78.00%VS 13.00%),敏感度和特异度分别为78.00%和87.00%;对高发区405例无症状人群3种自身抗体联合检测发现,87例抗体表达阳性(21.48%),阳性组共检出8例早期癌(9.20%),29例不典型增生(33.33%)和49例正常上皮(56.32%),明显高于自身抗体阴性(P<0.001);对高发区16212例无症状人群3种自身抗体联合检测共发现3096例阳性人群(19.10%);进一步对3096例阳性人群全部行色素内镜和黏膜活检,共检出393例早期食管癌(12.69%),30例中晚期食管癌(0.97%)和1053例不典型增生患者(34.01%)。结论STK15、P15和MLH1自身抗体联合检测是食管癌高危人群筛查的有效方法,可减少内镜检查对象,降低筛查成本,具有推广应用价值。Objective To investigate the application value of liquid biopsy in early warning and early detection of esophageal cancer high-risk subjects.Methods Indirect enzyme-linked immunosorbent assay(ELISA)was used to detect the autoantibodies of tumor associated antigen(STK15,P15,MLH1)between esophageal cancer group and normal group;in the high incidence area of esophageal cancer,serological detection and chromoendoscopy were performed in asymptomatic population;large scale asymptomatic screening was carried out in high incidence area of esophageal cancer,and chromoendoscopy was performed on subjects with positive serological test to understand the detection of esophageal cancer.Results Combined detection of three autoantibodies,the positive rate of serum autoantibodies in patients with esophageal cancer was 6 times higher than that in normal controls(78.00%VS.13.00%),and the sensitivity and specificity were 78.00%and 87.00%respectively;among 405 asymptomatic people in high incidence area,87(21.48%)cases were positive for three kinds of autoantibodies,8 cases of early cancer(9.20%),29 cases of atypical hyperplasia(33.33%)and 49 cases of normal epithelium(56.32%)were detected in the autoantibody positive group,which were significantly higher than those in the autoantibody negative group(P<0.001);a total of 3096 positive people(19.10%)were detected by combined detection of 3 autoantibodies in 16212 asymptomatic people in high incidence area;further,393 cases of early esophageal cancer(12.69%),30 cases of intermediate and advanced esophageal cancer(0.97%)and1053 cases of atypical hyperplasia(34.01%)were detected in 3096 cases of positive people by chromoendoscopy and mucosal biopsy.Conclusion STK15,p15 and MLH1 autoantibodies detection is an effective method for screening high-risk subjects of esophageal cancer;this method significantly reduces the number of endoscopic examination objects,reduing the cost of screening and having obvious population promotion and application value.

关 键 词：食管癌 自身抗体 液体活检 高危人群 预警 

分 类 号：R735.1[医药卫生—肿瘤]