摘要
目的:对10种肿瘤相关抗原(tumor-associated antigen,TAA)的自身抗体检测在原发性肝癌早期诊断中的价值进行评价,从而寻找一种真实可靠的肝癌早期诊断方法。方法:应用间接酶联免疫吸附试验(ELISA)检测原发性肝癌患者血清和正常人血清中的10种TAA(针对10个抗原Calnuc、CyclinE、CDK2、CIAP、RalA、p62、p53、Cy-clinB1、Koc、Imp1)的自身抗体,利用流行病学方法对检测结果的真实性进行评价。结果:每种TAA单独检测时,大多数指标的灵敏度偏低,但是肝癌患者抗体阳性率明显高于正常人;10种TAA两两联合起来时检测抗体阳性率,除了Calnuc抗体和CDK2抗体联合时阳性率为18.0%,其余联合均大于26.0%,明显高于单个抗体的检测结果,抗体阳性率最高达到50.0%,其中CyclinE和CIAP、CyclinE和Koc、CyclinE和Imp1等抗体阳性率均为50.0%;对10种TAA进行不同的组合,逐渐增加抗原数目进行检测,结果随着检测抗体的增多,诊断的灵敏度随之增加,10种抗体联合检测的灵敏度达到了88.0%,特异度也达到了86.2%,阳性预测值为84.6%,阴性预测值为89.3%。阳性似然比为6.25,阴性似然比为0.14,说明10种TAA检测肝癌的临床价值较高,Kappa值为0.74,提示该实验诊断结果与真实值之间高度一致。结论:利用10种TAA抗体组合检测肝癌具有较高的真实性,可作为现场高危人群筛检和临床中肝癌早期诊断的一种方法。
Objectives： To evaluate the diagnostic value of antibodies against a panel of ten tumor-associated antigens （TAAs） in the diagnosis of primary hepatocellular carcinoma （HCC） and to develop a valid and reliable diagnostic method for HCC. Methods： The antibodies against ten TAAs in sera from patients with primary HCC and normal human sera were detected by enzyme-linked immunosorbent assay （ELISA）. The validity of testing results for each anti-TAA antibody was evaluated by epidemiological methods. Results： When each anti-TAA antibody was judged individually the sensitivities were low, but the overall positive rate for HCC was higher than that for normal human sera. With the use of a two-antigen panel, the positive rate was higher than that for any individual TAA. The positive rate for the combination of Calnuc and CDK2 was 18.0% and more than 26.0% for other combinations, with the highest rate of 50.0% found using CyclinE and CLAP, CyclinE and Imp1, or CyclinE and Koc. With the successive addition of TAAs to a final total of ten antigens, there was a stepwise increase of positive antibody reactions reaching a sensitivity of 88.0% and a specificity of 86.2%. Positive and negative predictive values were 84.6% and 89.3%, respectively, which indicated that parallel assay of ten TAAs raised the diagnostic rate greatly. Positive likelihood ratio and negative likelihood ratio were 6.25 and 0.14, respectively, which showed that the clinical diagnostic value of parallel assay of ten TAAs was high. Kappa value was 0.74, indicating that the observed value of this assay had a high coincidence with the actual value. Conclusion： This study shows that a panel of ten TAAs can enhance antibody detection for diagnosis of hepatocellular carcinoma. This approach may be used as a screening tool for populations at high risk for hepatocellular carcinoma and as a routine test in clinical practice.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2008年第19期1112-1116,共5页
Chinese Journal of Clinical Oncology
基金
国家自然科学基金(编号:30471966)
河南省杰出人才创新基金资助(编号:0621002500)~~
关键词
肝癌
肿瘤相关抗原抗体
诊断试验
评价
Hepatocellular carcinoma （HCC）
Antibodies to tumor-associated antigen （TAA）
Diagnostic test
Evaluation
