【摘要】：目的:檢測N端α位乙酰基轉(zhuǎn)移酶10蛋白(N-α-acetyltransferase 10 protein,Naa10p)、癌胚抗原(Carcinoembryonic antigen,CEA)在口腔鱗狀細胞癌(Oral Squamous Cell Carcinoma,OSCC)患者、癌前病變患者和正常人唾液、血清中的表達,探討Naa10p、CEA與OSCC發(fā)生發(fā)展的關(guān)系及聯(lián)合檢測唾液中Naa10p、CEA對OSCC的診斷價值。方法:應(yīng)用ELISA法檢測76例OSCC患者、30例癌前病變患者和40例正常人唾液中Naa10p、CEA,血清中Naa10p的表達情況,并分析OSCC患者唾液中Naa10p、CEA,血清中Naa10p的表達與年齡、性別、族別、分化程度、臨床分期、腫瘤轉(zhuǎn)移等臨床參數(shù)的相關(guān)性。以病理學(xué)檢查結(jié)果為金標準繪制ROC曲線,評價各指標單項檢測及唾液中Naa10p、CEA聯(lián)合檢測對于診斷OSCC的診斷性能。結(jié)果:(1)OSCC組、癌前病變組、正常對照組唾液中Naa10p、CEA的表達兩兩之間差異均有統(tǒng)計學(xué)意義(P0.05)。無論是血清還是唾液,OSCC組中Naa10p表達均顯著高于正常對照組。無論是OSCC組還是正常對照組,唾液中Naa10p表達均顯著高于血清中表達。(2)OSCC組唾液中Naa10p表達與分化程度相關(guān),血清中Naa10p表達與年齡相關(guān),唾液中CEA表達與臨床分期、淋巴結(jié)轉(zhuǎn)移相關(guān)(P0.05),其余均無統(tǒng)計學(xué)意義(P0.05)。(3)繪制ROC曲線,唾液中Naa10p的ROC曲線下面積(0.924)明顯大于血清中Naa10p(0.713),差異有統(tǒng)計學(xué)意義(P0.05);唾液、血清中Naa10p的靈敏度、特異度、準確度分別為(85.40%、85.00%、85.30%)、(74.20%、65.00%、72.10%)。唾液中Naa10p、CEA單項和聯(lián)合檢測的靈敏度、特異度、準確度、陽性預(yù)測值、陰性預(yù)測值分別為(81.70%、72.50%、78.00%、81.70%、72.50%)、(88.30%、47.50%、72.00%、71.60%、26.90%)和(91.70%、80.00%、87.00%、87.30%、86.50%);唾液中Naa10p、CEA和聯(lián)合檢測的ROC曲線下面積分別為0.822、0.736、0.911,聯(lián)合檢測的ROC曲線下面積均大于任一單項檢測,差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:(1)Naa10p在OSCC患者唾液和血清中均高表達,唾液中Naa10p的表達與腫瘤分化程度相關(guān),提示Naa10p可能與OSCC的發(fā)生發(fā)展有關(guān),且唾液中Naa10p表達高于血清中,提示檢測唾液中Naa10p的表達比檢測血清中Naa10p對OSCC的診斷更具有臨床意義。(2)CEA在OSCC患者唾液中高表達,表明唾液中CEA亦可協(xié)助口腔鱗癌的診斷。(3)唾液中Naa10p、CEA聯(lián)合檢測有助于提高口腔鱗癌的診斷性能,是檢查口腔鱗癌較為理想的生物標志物組合。
[Abstract]:Objective: to detect the expression of N-terminal 偽 -acetyltransferase 10 protein,Naa10p (N- 偽 -acetyltransferase 10 protein,Naa10p) and carcinoembryonic antigen (Carcinoembryonic antigen,CEA) in saliva and serum of patients with oral squamous cell carcinoma (Oral Squamous Cell Carcinoma,OSCC), precancerous lesions and normal controls. To investigate the relationship between Naa10p,CEA and OSCC and the diagnostic value of Naa10p,CEA in saliva for OSCC. Methods: the expression of Naa10p in saliva of 76 patients with OSCC and 30 patients with precancerous lesion and 40 normal controls was detected by ELISA method. The expression of Naa10p in saliva of OSCC patients and age, sex, race, differentiation degree were analyzed. The correlation of clinical parameters such as clinical stage and tumor metastasis. The ROC curve was drawn according to the results of pathological examination as gold standard to evaluate the diagnostic performance of single item detection and Naa10p,CEA combined detection in saliva for diagnosis of OSCC. Results: (1) the expression of Naa10p,CEA in saliva of OSCC group, precancerous lesion group and normal control group were significantly different (P0.05). The expression of Naa10p in both serum and saliva OSCC group was significantly higher than that in normal control group. The expression of Naa10p in saliva was significantly higher than that in serum in both OSCC group and normal control group. (2) the expression of Naa10p in saliva of OSCC group was correlated with the degree of differentiation, the expression of Naa10p in serum was correlated with age, and the expression of CEA in saliva was correlated with clinical stage. The area under ROC curve of Naa10p in saliva (0.924) was significantly larger than that in serum (0.713), the difference was statistically significant (P0.05), the sensitivity, specificity and accuracy of Naa10p in saliva and serum were 85.30%, 85.30%, 75.20% and 72.10%, respectively. Sensitivity, specificity, accuracy, positive predictive value of single and combined detection of Naa10p,CEA in saliva, The negative predictive values were 72.50% (72.50%, 78.00%) and 72.50%), (88.30% (47.50%) and 71.60% (26.90%) and (91.7080.0087.30%, 87.3086.50%), respectively, and the area under the ROC curve of Naa10p,CEA in saliva and joint detection was 0.8220.7360.911, the area under the ROC curve of joint detection was larger than that of any single test, the difference was statistically significant (P0.05). Conclusion: (1) Naa10p is highly expressed in saliva and serum of OSCC patients. The expression of Naa10p in saliva is related to the degree of tumor differentiation, suggesting that Naa10p may be related to the occurrence and development of OSCC, and the expression of Naa10p in saliva is higher than that in serum. It is suggested that detecting the expression of Naa10p in saliva is more important than detecting Naa10p in serum for the diagnosis of OSCC. (2) the high expression of CEA in the saliva of OSCC patients. The results suggest that CEA in saliva can also help to diagnose oral squamous cell carcinoma. (3) combined detection of Naa10p,CEA in saliva is helpful to improve the diagnostic performance of oral squamous cell carcinoma and is an ideal biomarker combination for detection of oral squamous cell carcinoma.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R739.8

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