多种肿瘤自身抗体对结直肠癌诊断的应用价值

Application value of combined detection of tumor-associated autoantibodies in the diagnosis of colorectal cancer

目的探究联合检测多种肿瘤相关抗原自身抗体对结直肠癌诊断的应用价值。方法选取2017年5月至11月间收治于山东大学附属省立医院住院部的结直肠癌组、癌前病变组以及对照组血清标本及临床资料,采用酶联免疫吸附实验对纳入人群血清脱嘌呤/脱嘧啶核酸内切酶1(APE1)、微管关联蛋白RP/EB家族成员1(MAPRE1)、纽约食管鳞状细胞癌1(NY-ESO-1)自身抗体进行检测,采用ROC曲线对3种新型自身抗体以及传统指标癌胚抗原(CEA)、糖类抗原-199(CA-199)的诊断效能进行分析。结果 3组APE1 AAbs、MAPRE1 AAbs、NY-ESO-1 AAbs血清水平比较差异有统计学意义(P<0.01),且3种自身抗体的AUC值(0.772,95%CI:0.688～0.856;0.794,95%CI:0.716～0.873;0.854,95%CI:0.778～0.929)高于CA-199(0.571,95%CI:0.477～0.664)。NY-ESO-1 AAbs的AUC高于CEA(0.720,95%CI:0.639～0.801,P<0.05)。NY-ESO-1 AAbs+CEA组合的AUC(0.889, 95%CI:0.829～0.949)高于NY-ESO-1 AAbs(P=0.03),上述差异均有统计学意义。APE1 AAbs+NY-ESO-1 AAbs+CEA组合的AUC为0.927(95%CI:0.885～0.970),与NY-ESO-1 AAbs+CEA组合相比差异具有统计学意义(P=0.04)。结论 APE1 AAbs、NY-ESO-1 AAbs、CEA联合检测可提高结直肠癌的诊断效能,具有临床应用价值。

Objective To explore the application value of combined detection of tumor-associated autoantibodies in the diagnosis of colorectal cancer(CRC).Methods The serum specimens and clinical data of CRC patients(CRC group)and precancerous patients(precancerous group)treated in our hospital during May 2017 and November 2017,and the information of healthy controls(control group)were collected.The apurinic/apyrimidinic endonuclease 1(APE1),microtubule associated protein RP/EB family,member 1(MAPRE1)and New York esophageal squamous cell carcinoma 1(NY-ESO-1)autoantibodies levels were detected with enzyme-linked immunosorbent assay(ELISA).The diagnostic efficacies of three autoantibodies and traditional indicators(CEA and CA-199)were analyzed with receiver operating characteristic curve(ROC).Results There were significant differences in the levels of APE1 AAbs,MAPRE1 AAbs and NY-ESO-1 AAbs among the three groups.The area under the curve(AUC)of the 3 autoantibodies(0.772,95%CI:0.688-0.856;0.794,95%CI:0.716-0.873;0.854,95%CI:0.778-0.929)were higher than that of CA-199(0.571,95%CI:0.477-0.664,P<0.05).The AUC of NY-ESO-1 AAbs w as higher than that of CEA(0.720,95%CI:0.639-0.801,P<0.05).The AUC of NY-ESO-1 AAbs+CEA(0.889,95%CI:0.829-0.949)w as higher than that of NY-ESO-1 AAbs(P=0.03).The AUC of APE1 AAbs+NY-ESO-1 AAbs+CEA(0.927,95%CI:0.885-0.970)w as statistically higher than that of NY-ESO-1 AAbs+CEA(P=0.04).Conclusion The combined detection of APE1 AAbs,NY-ESO-1 AAbs and CEA can significantly improve the diagnostic efficacy of colorectal cancer,and it is w orth clinical application.