肿瘤相关抗原与自身抗体检测对食管癌早期发现和高危人群预警的意义

目的：探讨检测食管癌相关抗原与自身抗体对食管癌早期发现和高危人群预警的意义.方法：应用间接酶联免疫反应法和肿瘤相关抗原微阵列（包含8个重组的癌抗原蛋白C-myc、p53、cyclin B1、p16、p62、Koc、Imp1和Survivin）检测河南食管癌高发区无症状居民血清自身抗体.根据自身抗体变化对部分居民进一步作食管内镜检查和黏膜活检及免疫组织化学检测,了解血清自身抗体阳性和阴性居民食管上皮组织病理学变化特征及组织中相应肿瘤相关抗原变化的关系.结果：391例无症状居民中,79例（20%）至少呈现1种自身抗体阳性.对64例自身抗体阳性组和67例自身抗体阴性组居民进行内镜检查和黏膜活检组织病理学检查,发现2例早期食管癌,且均在抗体阳性组.血清自身抗体阳性组食管癌前病变发生率明显高于自身抗体阴性组,P＜0.01.阳性百分率随食管上皮病变加重呈现线性增高趋势.食管上皮组织中,8种肿瘤相关抗原表达与血清中相应自身抗体有明显相关性,P＜0.05.结论：血清肿瘤相关自身抗体检测有助于提高食管癌高发区无症状居民食管癌前癌变和早期食管癌的检出率.血清自身抗体与食管上皮组织中相应肿瘤抗原的表达变化明显相关.血清肿瘤相关自身抗体检测结合黏膜活检可能是食管癌早期发现和高危人群预警的重要手段.

Clinical significance of tumor-associated antigens and autoantibody measurement in high-risk subject screening and early detection of esophageal cancer

OBJECTIVE:To determine the significance of the tumor-associated antigen and autoantibody measurement in high-risk subject screening and early detection for esophageal cancer.METHODS:The enzyme-linked immunoassay and tumor-associated antigen mini-array(consisting of eight full-length recombinant proteins,including C-myc,p53,cyclin B1,p62,p16,Koc,Imp1,Survivin)were applied to determine the serum level of the auto-antibodies of these antigens on 391 symptom-free subjects from high incidence areas for esophageal cancer in Henan Province.Endoscopic biopsies and histopathological examination were performed based on autoantibody measurement.Immunohistochemistry was performed to correlate the expression of tumor-associated antigens in esophageal epithelia with the corresponding serum auto-antibodies.RESULTS:Of the 391 symptom-free subjects,79(20%)were observed with at least one kind of positive serum auto-antibodies.Endoscopic and histopathological examination on 64 cases with positive serum auto-antibodies and 67 cases with negative serum auto-antibodies showed that two cases with early esophageal cancer were identified in autoantibody positive group,the detection rate of esophageal precancerous lesions in autoantibody positive group was higher than that in negative group,P<0.05,and the positive percent of serum auto-antibodies increased with the mild to severe progression of the esophageal epithelial lesions.Furthermore,expressions of the total 8 tumor-associated antigens in esophageal tissue were correlated very well with the autoantibody measurement in serum.CONCLUSIONS:Measurement of tumor-associated auto-antibodies in serum may contribute to the higher detection rate of esophageal precancerous lesions and early esophageal cancer.Serum level of auto-antibodies is correlated well with the expression of corresponding tumor-associated antigens in esophageal epithelia tissue.Autoantibody measurement together with the endoscopic biopsy may be one of the key strategies in early detection of esophageal cancer and high-risk subject screening.