用柠檬酸提取人类骨胳肌蛋白抗原检测胸腺瘤相关抗体的临床应用价值

用柠檬酸提取人类骨胳肌肉膜蛋白抗原(CAE),先按间接血凝法(IHA)测103例重症肌无力(MG)血清中CAE-Ab,其中伴胸腺瘤者阳性率为78.9％(15/19);后改用ELISA方法,检测123例MG,其中伴胸腺瘤者阳性率为82.6％(19/23)。MG有胸腺瘤与无瘤、其他疾病及正常人组对照,抗体滴度相差非常显著(P<0.01)。结果表明CAE-Ab对MG伴胸腺瘤具有显著相关性。本文列举6例,说明临床采用敏感而又特异的CAE-Ab检测方法,可以早期发现胸腺瘤;中年以后MG患者常规检测CAEAb,可避免漏诊;即使瘤体徽小,CT扫描影像分辨不清,也可辅助临床诊断;病程中动态观察抗体滴度,可以发现隐藏着或复发的肿瘤,有助于随访,加强治疗。成批检测CAE-Ab时可出现少数“假阳性”、“假阴性”,诊断必须结合临床,综合分析。

Value on Clinical Application of Citric Acid Extracted Protein Antigen from Human Skeletal Muscle to Detect the Thymoma-associated Antibody

Thymus has an important significance to the pathogenesis and treatment for myasthenia gravis (MG). Thymoma accounts for 10 to 15% in the MG patients, which is short of localized damage feature so as to make misdiagnosis usually. Using citric acid extracted sacrolemma protein antigen from human skeletal muscle, CAE-Abs in the sera of 103 MG patients were detected by indirect hemoagglutination assay (IHA) and the positive rate was 78.9% (cases of 15/19); and then the CAE-Abs in the sera of 123 MG patients were detected by ELISA and the positive rate'was 82.6% (cases of 19/23). But the positive rate of CAE-Ab in the sera of MG without thymoma was only 0-4.0% (cases of 3/77). This results indicate that CAE-Ab has significant correlativity for MG with thymoma.