血清AchR-Ab和Titin-Ab在老年胸腺瘤合并重症肌无力患者中的表达及诊断价值分析

Expression and diagnostic value of serum AchR-Ab and Titin-Ab in elderly patients with thymoma combined with myasthenia gravis

目的探讨血清乙酰胆碱受体抗体(AchR-Ab)、连接素抗体(Titin-Ab)在老年胸腺瘤重症肌无力(TMG)患者中的表达情况及其诊断效能。方法选取老年TMG患者70例为TMG组,老年非胸腺瘤重症肌无力(NTMG)患者82例为NTMG组,老年健康体检者75例为健康对照组。比较不同组别受试者血清AchR-Ab、Titin-Ab的表达水平和阳性表达率,及TMG患者和NTMG患者不同组织中AchR-Ab、Titin-Ab的阳性表达率;分析AchR-Ab、Titin-Ab在TMG患者胸腺瘤组织和血清中阳性表达的相关性及血清AchR-Ab、Titin-Ab对TMG的诊断效能。结果TMG组受试者血清AchR-Ab、Titin-Ab的表达水平和阳性表达率均高于NTMG组和健康对照组,NTMG组受试者血清AchR-Ab、Titin-Ab的表达水平和阳性表达率均高于健康对照组,差异均有统计学意义(P﹤0.05)。胸腺瘤组织、胸腺瘤旁组织、胸腺增生组织和正常胸腺组织中AchR-Ab和Titin-Ab的阳性表达率比较,差异均有统计学意义(P﹤0.05);其中AchR-Ab和Titin-Ab的阳性表达率在胸腺瘤组织中最高,在正常胸腺组织中最低。TMG患者中,血清AchR-Ab的阳性表达与胸腺瘤组织中AchR-Ab的阳性表达呈正相关(r=0.632,P﹤0.01);血清Titin-Ab的阳性表达与胸腺瘤组织中Titin-Ab的阳性表达呈正相关(r=0.651,P﹤0.05)。血清AchRAb、Titin-Ab联合检测诊断TMG的效能高于两者单独检测(P﹤0.05)。结论TMG患者血清中AchR-Ab、Titin-Ab的表达上调,且两者在血清与肿瘤组织中的阳性表达呈正相关,两者联合检测对TMG的诊断效能较高。

Objective To investigate the expression and diagnostic efficacy of serum acetylcholine receptor-antibody (AchR-Ab) and Titin-Ab in elderly patients with thymoma combined with myasthenia gravis (TMG).Method Seventy elderly patients with TMG were included as TMG group,another 82 patients with nonthymomatous myasthenia gravis (NTMG) were included as NTMG group,and 75 healthy elderly patients were recruited as healthy control group.The serum AchR-Ab and Titin-Ab expression levels and positive expression rates in these different groups were compared,besides, the positive expression rates of AchR-Ab and Titin-Ab in multiple sites of tissues in TMG group and NTMG group were assessed.The correlation between positive expression of AchR-Ab and Titin-Ab in thymoma tissues and serum of TMG patients and the diagnostic efficacy of serum AchR-Ab and Titin-Ab in TMG patients were investigated.Result The expression levels and positive expression rates of serum AchR-Ab and Titin-Ab in the TMG group were higher than those in the NTMG group and healthy control group.The expression levels and positive expression rates of serum AchRAb and Titin-Ab in NTMG group were higher compared to healthy control group,the differences were statistically significan (P<0.05).The positive expression rates of AchR-Ab and Titin-Ab in thymoma tissues,para-thymoma tissue,thymic hyperplasia tissues,and normal thymus tissues were of statistical significance (P<0.05);AchR-Ab and Titin-Ab showed the highest positive rate in thymoma tissues,and were lowest in normal thymus tissues.The positive expression of serum AchR-Ab in TMG patients was positively correlated with the positive expression of AchR-Ab in thymoma tissues (r= 0.632,P<0.01).The positive expression of serum Titin-Ab in TMG patients was positively correlated with the positive expression of Titin-Ab in thymoma tissues (r=0.651,P<0.05).The diagnostic efficiency of combined detection of serum AchR-Ab and Titin-Ab was significantly higher than that of each test utilized alone (P<0.05).Conclusion The expression of AchR-Ab and Titin-Ab in serum of TMG patients are up-regulated,and their positive expression are positively correlated with each other in the serum and tumor tissues of those patients.The combined detection using both indicators is highly efficient in the diagnosis of TMG.