血清 DKK1和 P53自身抗体联合检测对食管鳞状细胞癌的诊断价值

Combined detection of serum DKK1 and P53 autoantibodies for the diagnostic value of esophageal squa-mous cell carcinoma

目的：探讨血清 DKK1（Dickkopf-1）和 P53自身抗体联合检测在食管鳞状细胞癌（ESCC）中的诊断意义。方法应用酶联免疫吸附试验检测126例 ESCC 患者和60例正常对照血清 DKK1和P53自身抗体的表达水平，采用受试者工作特征曲线（ROC）评价诊断效能。结果血清 DKK1水平和P53自身抗体在 ESCC 患者中的表达均明显高于正常对照[（673．09±343．82）pg／ml ∶（362．05±148．07）pg／ml，Z ＝6．158，P ＜0．0001；（0．398±0．546）∶（0．069±0．050），Z ＝3．832，P ＜0．0001]。ROC 曲线显示，当血清 DKK1为最佳诊断临界值588．77 pg／ml 时，其在诊断 ESCC 的曲线下面积（AUC）为0．780（95％CI 为0．715～0．844，敏感性为61．9％，特异性为95．0％）。P53自身抗体诊断 ESCC 的AUC 为0．674（95％CI 为0．598～0．750，敏感性为45．3％，特异性为95．0％）。DKK1和 P53自身抗体联合检测诊断食管癌的 AUC 为0．843（95％CI 为0．788～0．897，敏感性为73．8％，特异性为95．0％）。在早期 ESCC，DKK1和 P53自身抗体联合检测具有更好的诊断效能，AUC 为0．903（95％CI 为0．845～0．961，敏感性为81．0％，特异性为95．0％）。结论血清 DKK1和 P53自身抗体可作为 ESCC 的血清诊断标志物，联合检测有助于 ESCC 的早期诊断。

Objective To evaluate the diagnostic value of the combination of serum DKK1 （Dickkopf-1 ）and P53 autoantibodies in patients with esophageal squamous cell carcinoma （ESCC）.Methods Serum levels of DKK1 and P53 autoantibodies were measured by enzyme-linked immunosorbent assay （ELISA） for the 1 26 patients with ESCC and 60 normal controls.Receiver operating characteristics （ROC）was used to calculate the diagnostic efficiency.Results The serum levels of DKK1 and P53 autoantibodies were significantly higher in ESCC than those in normal controls [（673.09 ±343.82）pg/ml vs （362.05 ±1 48.07）pg/ml, Z =6.1 58,P〈;0.000 1 ;（0.398 ±0.546）vs （0.069 ±0.050）,Z =3.832,P〈0.000 1 ].ROC curves showed the optimum diagnostic cutoff for serum DKK1 was 588.77 pg/ml,with an area under curve （AUC）of 0.780 （95%CI：0.71 5 -0.844,61 .9% sensitivity,95.0% specificity）.Measurement of P53 autoantibodies demonstrated an AUC of 0.674 （95%CI：0.598 -0.750,45.3% sensitivity,95.0% specificity）.The combination of DKK1 and P53 autoantibodies yielded an AUC of 0.843 （95%CI：0.788 -0.897,73.8% sensitiv-ity,95.0% specificity）.In early-stage ESCC,combined detection of DKK1 and P53 autoantibodies improved the diagnostic power,with an AUC of 0.903 （95%CI：0.845 -0.961 ,81 .0% sensitivity,95.0% specificity）.Conclusion Serum DKK1 and P53 autoantibodies can be used as potential diagnostic biomarkers for the ESCC.Combined detection of them might aid the early diagnosis of ESCC.