六种肿瘤相关抗原自身抗体联合CA125检测对卵巢癌早期诊断的价值

摘要

目的:探讨肿瘤相关抗原(TAAs)P53、Survivin、IMP1、Cyclin D1、C-myc及Cyclin E自身抗体联合CA125检测对卵巢癌早期诊断的价值.方法:应用间接ELISA法检测78例原发性上皮性卵巢癌、60例卵巢良性肿瘤、100例正常对照血清中以上6种TAAs抗体,电化学发光法测定血清CA125含量.结果:卵巢癌患者血清中TAAs抗体的阳性率高于正常对照组(P均<0.05),每种TAA单独检测的阳性率为11.5%～35.9%;对6种TAAs抗体进行组合,随着联合抗体数目的增加,检测阳性率随之增加,6种TAAs抗体联合检测的阳性率为55.1%;6种TAAs抗体联合CA125检测卵巢癌的灵敏度为96.2%,特异度为76.0%,阳性预测值为75.8%,阴性预测值为96.2%,阳性似然比为6.25,阴性似然比为0.14;6种TAAs抗体联合CA125检测早期卵巢癌的阳性率为89.3%,明显高于单独应用CA125的检测阳性率(χ2=4.909,P=0.027).结论:利用6种TAAs抗体组合检测卵巢癌具有较高的真实性,可能为卵巢癌诊断提供一定的参考价值;6种TAAs抗体联合CA125检测可明显提高卵巢癌的检测灵敏度,特别是对早期卵巢癌的检测可能具有重要价值.%Aim:To evaluate the value of P53 , Survivin, IMP1, Cyclin Dl, C-myc,and Cyclin E with CA 125 in the early diagnosis of ovarian cancer. Methods:Autoantibodies against six tumor-associated antigen( TAAs ) in sera from 78 patients with primary epithelial ovarian cancer,60 patients with benign ovarian tumor and 100 healthy controls were analyzed using enzyme-linked immunosorbent assay. The levels of CA125 in sera were then examined by electrochemiluminescence method. Results:The levels of antibody against P53 , Survivin, IMP1, Cyclin Dl, C-myc and Cyclin E were significantly higher in all of the ovarian cancer patients than normal controls. The sensitivity of individual TAA antibody was from 11.5% in Cyclin E to 35. 9% in P53. However, with the successive addition of TAAs to a final total of six antigens, there was a stepwise increase in positivity which reached up to 55.1% . When detecting antibodies against six TAAs and CA125 together, the sensitivity reached up to 96.2%. Specificity, positive predictive value, negative predictive value, positive likelihood ratio and negative likelihood ratio were 76. 0% , 75. 8% , 96. 2% , 6. 25 and 0. 14,respectively. In early ovarian cancer patients, the sensitivity of detection of antibodies against six TAAs with CA125 together was about 89. 3% , which was obviously higher than using CA125 alone (X2 = 4. 909 ,P =0. 027 ) . Conclusion:The detection of antibodies against a mini-array of six TAAs namely P53 , Survivin, IMP1, CyclinDl, C-myc,and Cyclin E in combination with CA125 could increase the sensitivity of detecting ovarian cancer. And this may be an important reference value for diagnosis of ovarian cancer especially early stages of the disease.rnMicrowave assisted extraction of total flavonoids of stellera chamaejasme L.