消化系统肿瘤新标志抗survivin抗体的临床应用

Clinical application of anti-survivin antibody as a new tumor marker for carcinomas of digestive system

目的:建立生存素(survivin)抗体的检测方法,并进行临床标本检测.方法:用镍离子亲和层析纯化的survivin融合蛋白包被酶标板,建立基于重组融合蛋白的抗survivin抗体检测方法,并对434份血清标本进行检测,其中包括204例消化系统肿瘤,186例癌前病变和44例正常对照.结果:在204例消化系统肿瘤中,甲胎蛋白(AFP)和癌胚抗原(CEA)的阳性率分别为14.2%和16.7%,抗survivin抗体阳性率为30.9%,本方法的特异度为93.6%;在肠癌中CEA阳性率为11.1%(6/54),抗survivin抗体阳性率为44.4%(24/54,P<0.05);在胃癌中CEA阳性率为20%,抗survivin抗体阳性率为33.3%(P>0.05);在食管癌中,抗survivin抗体阳性率高达40%,CEA阳性率仅为6.7%(P<0.05).在186例癌前病变中,抗survivin抗体阳性率31.7%,AFP和CEA阳性率分别为10.8%和16.7%;在消化性溃疡患者中,抗survivin抗体和CEA阳性率均为33.3%;在直肠息肉中抗survivin抗体阳性率33.3%,CEA的阳性率仅为5.6%(P<0.05);在慢性结肠炎患者,抗survivin抗体阳性率40%,CEA阳性率20%(P<0.05).结论:建立的抗survivin抗体检测方法和对消化系统肿瘤抗survivin抗体检测的基础资料,可为抗survivin抗体作为消化系统肿瘤新标志分子研究奠定基础.

AIM： To establish an indirect ELISA-based method for detecting the anti-survivin antibody in sera of patients with digestive carcinomas and to discuss its clinical value. METHODS ： An indirect ELISA was established by coating recombinant survivin protein purified with Ni-NTA agarose affinity chromatography. Then 434 serum samples from digestive cancer patients （ n = 204） , precancerous lesion patients （n = 186） and normal subjects （ n = 44 ） were detected and analyzed. RESULTS ： The positive rates of alpha fetoprotein （AFP） , carcino-embryonic antigen （CEA） and anti-survivin antibody in the sera of 204 patients of digestive carcinomas were 14.2%, 16.7% and 30.9% , respectively. The specificity of this method was 93.6%. CEA and the elevated antiurvivin antibody were detected in 11. 1% （6/ 54） and 44, 4% of intestinal carcinoma specimens （24/54, P 〈 0.05 ）, The positive rates of CEA and anti-survivin antibody in gastric carcinoma specimens were 20% and 33.3% （ P 〉 0, 05 ）. Anti-survivin positive patients were 6 of 15 （40%） and CEA positive patients were 1 of 15 （6, 7% , P 〈0, 05） in esophageal carcinoma. The positive rates of AFP, CEA and anti-survivin antibody in 186 patients with precancerous lesions of digestive system were 10, 8%, 16, 7% and 31.7% , respectively （P 〈 0, 05 ）, The positive rates of CEA and anti-survivin antibody in patients with peptic ulcer were both 33, 3%, Anti-survivin positive rate was 33, 3% （24/72） and CEA positive rate was 5, 6% （3/72, P 〈 0, 05 ） in patients of proctopolypus, In patients of chronic colitis, CEA and the elevated anti-survivin antibody were detected in 6 of 30 （20%） and 12 of 30 specimens （40% , P 〈0.05 ）. CONCLUSION： The detection method of anti-survivin antibody and the data got in the study of the antibody prevalence in carcinomas of digestive system provide an important basis for further research on anti-survivin antibody as a tumor marker.