一种新的液体活检技术在食管癌高发区无症状人群早期食管癌筛查中的应用  

Application of a liquid technique in early esophageal cancer screening of asymptomatic residents of high incidence area

作　　者：程锟 赵学科[1] 周福有[3] 王盼盼[1] 钟侃 胡景峰 宋昕[1] 王伟[1,2] 李欣然[1] 杨苗苗 徐瑞华[1] 魏梦霞 韩文莉 雷玲玲 孟超龙 胡守佳 王建坡[4] 王能超[5] 鲍启德[6] 王立东[1] CHENG Kun;ZHAO Xueke;ZHOU Fuyou;WANG Panpan;ZHONG Kan;HU Jingfeng;SONG Xin;WANG Wei;LI Xinran;YANG Miaomiao;XU Ruihua;WEI Mengxia;HAN Wenli;LEI Lingling;MENG Chaolong;HU Shoujia;WANG Jianpo;WANG Nengchao;BAO Qide;WANG Lidong(State Key Laboratory of Esophageal Cancer Prevention&Treatment and Henan Key Laboratory for Esophageal Cancer Research,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052,China;Department of Pathology and Pathophysiology,School of Basic Medicine,Zhengzhou University,Zhengzhou 450052,China;Department of Thoracic Surgery,Anyang Cancer Hospital,Anyang 455000,China;Cancer Prevention Office,Anyang Cancer Hospital,Anyang 455000,China;Department of Radiotherapy,Anyang Cancer Hospital,Anyang 455000,China;Department of Oncology,Anyang District Hospital,Anyang 455000,China)

机构地区：[1]郑州大学第一附属医院河南省食管癌重点开放实验室、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]安阳市肿瘤医院胸外科,河南安阳455000 [4]安阳市肿瘤医院肿瘤防治办公室,河南安阳455000 [5]安阳市肿瘤医院放疗科,河南安阳455000 [6]濮阳安阳地区医院肿瘤科,河南安阳455000

出　　处：《肿瘤基础与临床》2020年第5期391-395,共5页journal of basic and clinical oncology

基　　金：国家自然科学基金资助项目(U1301227)。

摘　　要：目的探究一种新的液体活检技术在食管癌高危人群预警和食管癌早期发现中的应用。方法利用间接酶联免疫吸附试验对食管癌组和正常组研究对象进行血清学肿瘤相关抗原自身抗体[增殖细胞核抗原(PCNA)、转化生长因子β受体Ⅱ(TβRⅡ)和着色性干皮病基因组C(XPC)]检测。在食管癌高发区对无症状人群行液体活检和色素内镜检查,并对2种方法进行比较。在食管癌高发区行大规模无症状人群筛查,并对液体活检阳性者行色素内镜检查,了解食管癌检出情况。结果PCNA、TβRⅡ、XPC等3种肿瘤相关抗原自身抗体在食管癌组(43.75%、37.50%、42.50%)的阳性率明显高于对照组(10.00%、10.00%、11.25%),差异均有统计学意义(χ^2=23.184,P<0.001;χ^2=16.704,P<0.001;χ^2=19.877,P<0.001)。3种肿瘤相关抗原自身抗体联合检测对早期食管癌患者敏感性和特异性分别为81.25%和81.25%。对食管癌高发区518例无症状人群进行3种肿瘤相关抗原自身抗体联合液体活检发现,阳性者食管癌检出率为9.91%,明显高于阴性者的0.25%,差异有统计学意义(χ^2=133.343,P<0.001)。对食管癌高发区21428例无症状人群进行3种肿瘤相关抗原自身抗体联合液体活检共发现4286例阳性(20.00%),进一步对4286例阳性人群行色素内镜检查共检出545例早期食管癌(12.72%),占整个无症状人群的2.54%。结论血清肿瘤相关抗原自身抗体PCNA、TβRⅡ和XPC联合液体活检能够有效筛查食管癌高危人群,且显著减少了内镜检查对象,降低了筛查成本,具有很高的推广应用价值。Objective To explore the application of a new liquid biopsy technique in early warning and early detection of esophageal cancer in the high risk population.Methods Indirect enzyme-linked immunosorbent assay was used to detect the serum tumor associated antigen autoantibodies[proliferating cell nuclear antigen(PCNA),transforming growth factor beta receptorⅡ(TβRⅡ)and xeroderma pigmentosum genome C(XPC)]in the esophageal cancer group and the control group.In the high incidence area of esophageal cancer,liquid biopsy and chromoendoscopy were performed in asymptomatic people,and the two methods were compared.Large scale asymptomatic population screening was performed in the high incidence area of esophageal cancer,and chromoendoscopy was performed in the patients with positive liquid biopsy to understand the detection of esophageal cancer.Results The positive rates of PCNA,TβRⅡand XPC in the esophageal cancer group(43.75%,37.50%and 42.50%)were significantly higher than those in the control group(10.00%,10.00%and 11.25%)(χ^2=23.184,P<0.001;χ^2=16.704,P<0.001;χ^2=19.877,P<0.001).The sensitivity and specificity were 81.25%and 81.25%respectively.The 518 cases of asymptomatic people in the high incidence area of esophageal cancer were detected by three kinds of tumor associated antigen autoantibodies liquid biopsy,the positive rate of esophageal cancer was 9.91%,which was significantly higher than 0.25%in the negative group(χ2=133.343,P<0.001).Among 21428 cases of asymptomatic people in the high incidence area of esophageal cancer,4286 cases(20.00%)were positive for three kinds of tumor associated antigen autoantibodies liquid biopsy,and 545 cases(12.72%)of early esophageal cancer were detected by chromoendoscopy,accounting for 2.54%of the whole asymptomatic population.Conclusion Liquid biopsy(serum autoantibodies of PCNA,TβRⅡand XPC)can effectively screen the high risk population of esophageal cancer;this method can significantly reduce the number of endoscopic examination and the cost of screening,and has

关 键 词：食管癌 液体活检 自身抗体 高危人群 早期发现 

分 类 号：R735.1[医药卫生—肿瘤]