本文選題：抗survivin抗體　切入點：抗P53抗體　出處：《重慶醫(yī)科大學(xué)》2011年碩士論文

【摘要】：目的: 喉癌是最常見的頭頸部惡性腫瘤之一,能否早期診斷是提高喉癌5年生存率的最主要原因之一。因此目前,尋找理想的檢測手段是喉癌研究領(lǐng)域的熱點之一。本實驗采用酶聯(lián)免疫吸附雙抗體夾心法(ELISA)檢測喉癌患者外周血清中抗survivin抗體,抗p53抗體的陽性率,同時檢測單純手術(shù)治療后一定時期內(nèi)喉癌患者,正常對照組實驗樣本中抗survivin抗體,抗p53抗體的陽性率。通過比較各實驗組陽性率的差異,探討抗survivin抗體,抗p53抗體在喉癌早期診斷中的意義。分析抗survivin抗體,抗p53抗體與喉癌患者各臨床病理參數(shù),腫瘤分期之間的關(guān)系,探討抗survivin抗體,抗p53抗體在判斷手術(shù)療效及預(yù)測復(fù)發(fā)中的意義。 方法: 1.收集經(jīng)病檢證實為喉癌的所有住院患者(無其它原發(fā)性惡性腫瘤,術(shù)前未經(jīng)放療,化療,且知情同意患者),包括術(shù)前組:31例未經(jīng)治療喉癌患者血清,平均年齡62.6歲;術(shù)后10天組:術(shù)前組患者術(shù)后第10天血清25例;術(shù)后17天組,術(shù)前組患者術(shù)后第17天血清23例。所有術(shù)后組樣本均為手術(shù)切緣病理檢查陰性。術(shù)后組患者也未經(jīng)放療,化療。 2.酶聯(lián)免疫吸附雙抗體夾心法(ELISA)檢測所有實驗組樣本中抗survivin抗體,抗p53抗體的OD值,以正常對照組血清OD均值加2倍標準差作為陰性血清的臨界值,高于此值的即判為陽性。 3.數(shù)據(jù)分析:使用SPSS 17.0軟件包,陽性率比較采用Fisher確切概率法進行檢驗,各組間OD值比較采有秩和檢驗,均以P0.05為差異有統(tǒng)計學(xué)意義。 結(jié)果: 1.術(shù)前組中抗survivin抗體陽性率明顯高于術(shù)后組及正常對照組(P0.05)。但與既往研究不同的是,我們的研究顯示在喉癌患者不同分期中(I +II期,III + IV期)有明顯統(tǒng)計學(xué)差異(P0.05)。 2.通過術(shù)前組中抗p53抗體陽性率,OD值與術(shù)后組及正常對照組比較發(fā)現(xiàn),術(shù)前組中抗p53抗體陽性率及OD值明顯高于術(shù)后組及正常對照組(P0.05)。同時在喉癌患者不同分期中(I +II期,III + IV期)有明顯統(tǒng)計學(xué)差異(P0.05)。 3.抗survivin抗體,抗p53抗體聯(lián)合檢測時,其陽性率(67.7%)高于單一抗體在喉癌中的陽性率。 結(jié)論: 1.雖然靈敏度偏低,但較高的特異度和陽性預(yù)測值,及術(shù)后喉癌患者血清中抗survivin抗體的低表達,術(shù)后組與正常對照之間的無差異性表達,使得抗survivin抗體具有成為一種新喉癌標記分子的可能性。 2.抗p53抗體在喉癌的診斷中有著非常重要的地位,具有成為一種新的喉癌標記分子的潛在可能;喉癌患者血清中抗p53抗體可能是一種判斷療效及篩選復(fù)發(fā)高�；颊叩挠行е笜�。 3.抗體聯(lián)合檢測能夠有效地提高喉癌患者的陽性檢出率,在喉癌早期診斷中具有一定的應(yīng)用價值,診斷意義高于單一抗體檢測。術(shù)后抗survivin抗體及抗p53抗體的聯(lián)合檢測對于我們判斷手術(shù)范圍,為臨床醫(yī)師篩選術(shù)后復(fù)發(fā)的高�；颊咛峁┯幸鎱⒖�。
[Abstract]:Objective:. Laryngeal cancer is one of the most common malignant tumors in the head and neck. Early diagnosis is one of the most important reasons to improve the 5-year survival rate of laryngeal cancer. In this study, Elisa double antibody sandwich method was used to detect the positive rate of anti survivin antibody and anti p53 antibody in peripheral serum of laryngeal cancer patients. At the same time, the positive rates of anti survivin antibody and anti p53 antibody in the patients with laryngeal cancer and normal control group were detected in a certain period after simple surgical treatment. The positive rates of anti survivin antibody and anti p53 antibody in each experimental group were compared to explore the anti survivin antibody. The significance of anti p53 antibody in the early diagnosis of laryngeal carcinoma. The relationship between anti survivin antibody, anti p53 antibody and the clinicopathological parameters and tumor stage of laryngeal carcinoma was analyzed, and the anti survivin antibody was discussed. The significance of anti-p53 antibody in evaluating surgical efficacy and predicting recurrence. Methods:. 1. To collect all patients with laryngeal cancer confirmed by disease examination (no other primary malignant tumor, no preoperative radiotherapy, chemotherapy, and informed consent patients), including preoperative group of 31 patients with untreated laryngeal cancer serum, the average age was 62.6 years; Ten days after operation, 25 patients in the preoperative group and 23 patients in the preoperative group on the 17th day after operation. All the postoperative samples were negative in the surgical margin. The patients in the postoperative group were also not treated with radiotherapy or chemotherapy. 2.Enzyme-linked immunosorbent assay (Elisa) was used to detect the OD value of anti survivin antibody and anti p53 antibody in the samples of all experimental groups. The serum OD mean and 2 times standard deviation of normal control group were taken as the critical value of negative serum, and those above this value were judged to be positive. 3. Data analysis: using SPSS 17.0 software package, the positive rate was tested by Fisher exact probability method, and the OD value of each group was compared by rank sum test. Results:. 1. The positive rate of anti survivin antibody in preoperative group was significantly higher than that in postoperative group and normal control group (P 0.05). 2.The positive rate and OD value of anti-p53 antibody in the preoperative group were compared with those in the postoperative group and the normal control group. The positive rate and OD value of anti-p53 antibody in preoperative group were significantly higher than those in postoperative group and normal control group (P 0.05). 3. The positive rate of anti survivin antibody and anti p53 antibody was 67.7% higher than that of single antibody in laryngeal carcinoma. Conclusion:. 1. Although the sensitivity was low, the specificity and positive predictive value were higher, and the expression of anti survivin antibody in postoperative laryngeal cancer patients was low, and there was no difference between postoperative group and normal control group. It is possible that anti-survivin antibody can become a new marker of laryngeal cancer. 2. Anti-p53 antibody plays a very important role in the diagnosis of laryngeal carcinoma and has the potential to become a new marker of laryngeal cancer, and the anti-p53 antibody in serum of laryngeal cancer patients may be an effective index for judging the curative effect and screening the patients with high risk of recurrence. 3. The combined detection of antibody can effectively improve the positive rate of laryngeal cancer patients, and has certain application value in the early diagnosis of laryngeal carcinoma. The diagnostic significance is higher than that of single antibody detection. The combined detection of anti survivin antibody and anti p53 antibody is helpful for us to judge the scope of operation and to provide a useful reference for clinicians to screen high risk patients with postoperative recurrence.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R739.65

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