【摘要】：國處于全球食管癌的高發(fā)地區(qū),食管鱗癌發(fā)病率和死亡率在我國分別居惡性腫瘤的第五和第四位,極大影響著我國人民的健康。食管鱗癌具有起病隱匿、進(jìn)展快、侵襲性強(qiáng)等特點(diǎn),確診時(shí)往往已處于晚期。食管鱗癌的總體五年生存率僅20%左右,而如果能早期發(fā)現(xiàn)和治療,Ⅰ期食管鱗癌的五年生存率可以達(dá)到70-80%。因此若能找到有效的早期發(fā)現(xiàn)方法,是提高食管鱗癌整體預(yù)后的根本措施。當(dāng)今常用的篩查手段,諸如胃鏡、X線造影等,存在有創(chuàng)、操作復(fù)雜、檢測周期長、敏感性低等缺點(diǎn),不適于推廣至大范圍人群。血清標(biāo)志物則具有操作簡便、相對無創(chuàng)、經(jīng)濟(jì)、快速等優(yōu)勢,適合作為廣泛人群篩查的手段。本項(xiàng)研究試圖尋找早期診斷食管鱗癌的血清標(biāo)志物組合,以提高食管鱗癌的早期診斷率,進(jìn)而改善該病的整體預(yù)后水平。研究取用食管鱗癌患者血清和健康人血清分別作為實(shí)驗(yàn)組和對照組樣本。選取近年來文獻(xiàn)報(bào)道效果較突出的7種分泌蛋白標(biāo)志物：CEA、Cyfra21-1、SCC、DKK-1、 MIC-1、HGF和LY6K,用ELISA方法首先進(jìn)行小樣本(n=50)檢測,篩選出4個(gè)因子CEA、Cyfra21-1、SCC和MIC-1后,進(jìn)一步進(jìn)行了較大樣本(n=196)血清標(biāo)志物聯(lián)合分析。結(jié)果顯示,4種標(biāo)志物聯(lián)合檢測食管鱗癌的敏感性、特異性、準(zhǔn)確性分別為75.0%、65.8%、70.4%,優(yōu)于任何一種標(biāo)志物單一檢測的診斷效率。另外,研究還嘗試檢測了自身血清P53抗體標(biāo)志物。經(jīng)過摸索實(shí)驗(yàn)條件,初步建立了檢測自身抗體的實(shí)驗(yàn)方案。小規(guī)模(n=25)檢測結(jié)果顯示,P53抗體在食管鱗癌患者血清中表達(dá)水平顯著高于正常對照。通過本項(xiàng)研究,初步探究了早期診斷食管鱗癌的血清標(biāo)志物,獲得了優(yōu)于現(xiàn)有標(biāo)志物的新標(biāo)志物組合,具有潛在的臨床應(yīng)用前景。
[Abstract]:China is in a high incidence of esophageal cancer in the world, the incidence and mortality of esophageal squamous cell carcinoma ranks fifth and fourth in China respectively, which greatly affects the health of our people. Esophageal squamous cell carcinoma has the characteristics of hidden onset, rapid progress and strong invasiveness, and is often in the late stage at the time of diagnosis. The overall five-year survival rate of esophageal squamous cell carcinoma was only about 20%. If early detection and treatment, the 5-year survival rate of stage I esophageal squamous cell carcinoma could reach 70% 80%. Therefore, if we can find an effective early detection method, it is the fundamental measure to improve the overall prognosis of esophageal squamous cell carcinoma. Nowadays, the commonly used screening methods, such as gastroscopy, X-ray radiography and so on, have some shortcomings, such as invasive, complex operation, long detection cycle, low sensitivity and so on, so they are not suitable for wide population. Serum markers have the advantages of simple operation, non-invasive, economical and rapid, and are suitable for screening a wide range of people. This study attempts to find a combination of serum markers for early diagnosis of esophageal squamous cell carcinoma in order to improve the early diagnosis rate of esophageal squamous cell carcinoma and thus improve the overall prognosis of the disease. The serum of patients with esophageal squamous cell carcinoma and healthy human serum were taken as experimental group and control group, respectively. Seven secretory protein markers reported in the literature in recent years were selected: CEA,Cyfra21-1,SCC,DKK-1, MIC-1,HGF and LY6K, were first detected by ELISA method (n 鈮，

本文編號：2480426