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目的:探讨食管和贲门癌及癌前病变患者血清中多个肿瘤相关自身抗体的变化特征及其在食管和贲门癌高危人群筛查和早期诊断中的意义。方法:应用间接酶联免疫反应法和肿瘤相关抗原微阵列(包含8个重组的癌抗原蛋白:C-myc、p53、cyclinB1、p16、p62、Koc、IMP1和Survivin)检测376例食管和贲门各级病变患者(正常、癌前病变和癌)血清中的自身抗体。结果:在所检测的八种抗原中,p53、C-myc、cyclinB1、IMP1和p62从正常食管到癌前病变及癌患者血清中和p53、C-myc、p16、p62在正常贲门到癌前病变及癌患者血清中阳性百分率均具有线性升高趋势。单一抗体对食管和贲门癌检出率较低,p53在癌血清中的表达阳性率在所有抗原中最高,在食管癌和贲门癌患者中分别为23%(13/57)和21%(9/43)。但是,当应用8个抗原分析时,至少有1个反应为阳性时,其检出阳性率明显增高,食管和贲门癌的阳性检出率分别提高到63%(36/57)和61%(26/43),上述检测指标在正常食管和贲门与相应各级癌前病变和癌患者阳性表达率差异有统计学意义,P<0·05。结论:联合应用多个肿瘤相关抗原比应用单个肿瘤相关抗原分析食管和贲门癌及癌前病变患者血清中的自身抗体变化能够提高癌和癌前病变患者的检出率。食管和贲门癌多个相关抗原微阵列的进一步优化有可能成为临床上食管和贲门癌和高危人群检测和早期诊断的非侵袭性方法。
Objective: To investigate the characteristics of multiple tumor-associated autoantibodies in serum of patients with esophageal and cardiac cancers and precancerous lesions and its significance in screening and early diagnosis of esophageal and cardiac cancer high-risk populations. METHODS: Three hundred and sixty-six cases of esophageal and cardiac cancers were detected by indirect enzyme-linked immunosorbent assay and tumor-associated antigen microarray (containing eight recombinant cancer antigen proteins: C-myc, p53, cyclinB1, p16, p62, Koc, IMP1, and Survivin). Autoantibodies in the serum of patients (normal, precancerous, and cancerous). Results: Of the eight antigens tested, p53, C-myc, cyclinB1, IMP1, and p62 were from normal esophagus to precancerous lesions, serum from patients with cancer, and p53, C-myc, p16, and p62 were normal to precancerous. The positive percentage of serum in lesions and cancer patients showed a linear increase. The detection rate of single antibody against esophageal and cardiac cancers was low, and the positive rate of p53 expression in cancerous serum was highest among all antigens, and was 23% (13/57) and 21% in patients with esophageal and cardiac cancers (9) / 43). However, when 8 antigens were used for analysis, at least 1 was positive, the positive rate was significantly higher, and the positive rate of esophageal and cardiac cancers increased to 63% (36/57) and 61% ( 26/43), the above-mentioned detection indicators in the normal esophagus and fontanelle and corresponding precancerous lesions and cancer patients positive expression rate difference was statistically significant, P<0.05. Conclusions: Combined use of multiple tumor-associated antigens compared to the use of single tumor-associated antigens to analyze autoantibody changes in serum of patients with esophageal and cardiac cancer and precancerous lesions can increase the detection rate of cancer and precancerous lesions. Further optimization of multiple relevant antigen microarrays for esophageal and cardiac cancers may become a non-invasive method for clinical detection and early diagnosis of esophageal and cardiac cancers and high-risk individuals.