外周血T淋巴细胞AgNOR检测在食管癌诊断中的应用  

Diagnostic Application of Detecting AgNOR in Peripheral Blood T Lymphocyte in Patients with Esophageal Carcinoma

作　　者：王军业[1] 戎铁华[1] 梁伊仁[2] 龙浩[1] 陈巧伦[2] 马国伟[1] 

机构地区：[1]中山大学肿瘤防治中心胸科,广东广州510060 [2]中山大学肿瘤防治中心检验科,广东广州510060

出　　处：《癌症》2004年第5期577-580,共4页Chinese Journal of Cancer

摘　　要：背景与目的:评估肿瘤组织分裂间期的AgNOR定量分布已被广泛应用于肿瘤的诊断、疗效判断和预后评估。肿瘤免疫学证实肿瘤可诱发免疫抑制,测定T淋巴细胞核仁区的AgNOR活性表达可以探知T淋巴细胞的免疫活性状态。监测外周血T淋巴细胞AgNOR活性表达在食管癌方面的研究较少。本研究旨在探讨外周血T淋巴细胞AgNOR的活性检测在食管癌患者诊断中的应用价值。方法:检测75例健康人、276例食管癌患者的外周血,利用KL型肿瘤免疫图像分析系统检测AgNOR含量(AgNOR面积与细胞面积的比值,即I/S%);同时用微粒子酶免疫分析技术、双抗体夹心法与化学比色法分别检测癌胚抗原(CEA)、鳞状上皮细胞癌相关抗原(SCC)、恶性肿瘤相关物质群(TSGF)的表达。结果:(1)食管癌患者外周血T淋巴细胞AgNOR的活性表达(5.64±0.89)明显低于健康人(7.07±0.81)(P=0.000),灵敏度0.674,特异度0.920,Youden指数0.59,Roc曲线下面积为0.886。(2)食管癌患者AgNOR阳性率(67.4%)明显高于CEA(12.86%)、SCC(15.04%)、TSGF(36.49%),差异具有显著性意义(P<0.001);AgNOR与CEA、SCC、TSGF间的相关性无统计学意义(P>0.05)。(3)食管癌患者AgNOR阳性率明显高于CEA+SCC+TSGF联合检测的阳性率(54.4%),差异具有显著性意义(P=0.018),而与AgNOR+CEA、AgNOR+SCC。BACKGROUND &OBJECTIVE: Evaluation of the quantitative distribution of interphase AgNOR (argyrophilic nucleolar organizer regions) has been widely used for diagnostic and prognostic purposes of tumor. It has been proven by tumor immunology that tumor can induce host immunosuppression. T lymphocyte immune activity can be reflected by detecting AgNOR expression in nucleolar organizer regions. There are few reports about AgNOR expression in peripheral blood T lymphocyte of the patients with esophageal carcinoma. In this investigation, AgNOR expression in peripheral blood T lymphocyte was systematically evaluated in a serial of patients with esophageal carcinomas to determine its value in diagnosis of the patients. METHODS: AgNOR expression in peripheral blood T lymphocyte of 276 patients with esophageal carcinoma and 75 healthy controls were measured by microphotometry with the technique of silver stain. At the same time, carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC) and tumor specific growth factor (TSGF) were also measured by microparticle enzyme immune analysis, bio antibody sandwich, and chemo chromatometry. RESULTS: (1) AgNOR expression in peripheral blood T lymphocyte of the patients with esophageal carcinoma (5.64±0.89) were much lower than that of control group (7.07±0.81)(P=0.000). The positive rate, sensitivity, and specificity were 67.4%, 0.674, and 0.920, respectively. Youden index was 0.59 and the area under receiver operator characteristic (ROC) curve was 0.886. (2) The positive rate of AgNOR (67.4%) was higher than those of CEA (12.86%), SCC (15.04%), and TSGF (36.49%) in patients with esophageal carcinoma (P< 0.001). There was no relationship between AgNOR expression and CEA, SCC, and TSGF (P>0.05). (3) AgNOR expression has a higher positive rate in patients with esophageal carcinoma than the combined positive rate of CEA, SCC, and TSGF (P = 0.018), but has a similar positive rate with those of AgNOR+CEA, AgNOR+SCC, or AgNOR+CEA+SCC, with no statistical difference (P >0.05)

关 键 词：外周血T淋巴细胞 AGNOR检测 食管癌 诊断 治疗效果 

分 类 号：R735.1[医药卫生—肿瘤]