MDM2、GSTπ和STAT3抗原自身抗体联合检测在食管癌早筛中的应用  

Application of Combined Detection of MDM2,GSTπand STAT3 Antigen Autoantibodies in Early Screening of Esophageal Cancer

作　　者：韩文莉 赵学科[1] 张立国[2] 雷玲玲 孟超龙 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 李志强 刘太江 张高富 李秀敏[5,6] 陈志国[6] 王立东[1] HAN Wen-li;ZHAO Xue-ke;ZHANG Li-guo;LEI Ling-ling;MENG Chao-long;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-xia;LI Zhi-qiang;LIU Tai-jiang;ZHANG Gao-fu;LI Xiu-min;CHEN Zhi-guo;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 Thoracic Surgery,Xinxiang Central Hospital,Xinxiang 453003,China;Department of Oncology,Huixian Third People's Hospital,Xinxiang 453003,China;Department of Oncology,Xinxiang Allied Hospital,Xinxiang 453003,China;Department of Gastroenterology,Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,China;Henan Key Laboratory for Molecular Therapy of Cancer,Xinxiang Medical University,Xinxiang 453003,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]新乡市中心医院胸外科,河南新乡453003 [3]辉县市第三人民医院肿瘤科,河南新乡453003 [4]新乡同盟医院肿瘤科,河南新乡453003 [5]新乡医学院第三附属医院消化内科,河南新乡453003 [6]新乡医学院河南省肿瘤分子治疗医学重点实验室,河南新乡453003

出　　处：《食管疾病》2020年第4期260-264,共5页Journal of Esophageal Diseases

基　　金：国家科技部863重大专项(2012AA02A503)。

摘　　要：目的探讨食管癌相关血清自身抗体对食管癌早期发现和高危人群预警的意义。方法通过间接酶联免疫吸附试验法(ELISA)检测食管癌患者和正常人群血清中MDM2、GSTπ和STAT3抗体表达的差异。对新乡市辉县市食管癌高发区的无症状人群进行检测,根据血清自身抗体表达变化对部分居民作黏膜和内镜活检,了解血清自身抗体表达与食管癌发生的关系。结果联合检测人血清中MDM2、GSTπ和STAT3这3种TAA的抗体表达水平,可以有效检测食管癌,尤其是早期食管癌,其检测灵敏度高达85%,特异性达到了70%;431例无症状人群血清学检测检出89例高危人群,黏膜活检确诊食管癌和癌前病变43例,其中高危人群中检出36例(83.72%),P<0.001;对8802例无症状人群进行血清学检测,检出1584例高危人群(18.00%),对这1584例高危人群进行内镜检查,检出癌前病变352例(4.00%,352/8802);确诊210例食管癌(2.39%,210/8802),其中早期食管癌患者198例。结论3种肿瘤相关抗原(tumor associated antigen,TAA)的抗体联合检测有助于提高食管癌检出率,血清自身抗体结合内镜和黏膜活检可能是食管癌早期发现的重要途径。Objective To investigate the significance of serum autoantibodies related to esophageal cancer in early detection and early warning of high-risk population.Methods Indirect enzyme-linked immunosorbent assay(ELISA)was used to detect the difference of MDM2,GSTπand STAT3 antibody expression in serum between esophageal cancer patients and normal people;the asymptomatic population in high incidence area of esophageal cancer in Huixian of Xinxiang City was detected,and mucosal and endoscopic biopsies were performed on some residents according to the changes of serum autoantibody expression to understand the relationship between serum autoantibody expression and esophageal cancer Relationship.Results Combined detection of MDM2,GSTπand STAT3 in human serum can effectively detect esophageal cancer,especially early esophageal cancer.The sensitivity and specificity of detection were 85%and 70%,respectively.Among 431 asymptomatic subjects,89 high risk subjects were detected.Mucosa biopsy confirmed 43 cases of esophageal cancer and precancerous lesions,36 cases(83.72%,P<0.001)were detected in high-risk subjects;In this study,1584 high-risk subjects(18.00%)were detected by serology detection in 8802 asymptomatic populations.Among the 1584 high risk subjects,352 cases(4.00%,352/8802)had precancerous lesions and 210 cases(2.39%,210/8802)of esophageal cancer were diagnosed,including 198 patients with early esophageal cancer Conclusion The combined detection of three TAA antibodies is helpful to improve the detection rate of esophageal cancer.Serum autoantibodies combined with endoscopy and mucosal biopsy may be an important way for early detection of esophageal cancer.

关 键 词：食管癌 血清自身抗体 早期发现 

分 类 号：R735.1[医药卫生—肿瘤]