抗survivin抗体、抗p53抗体检测在喉癌中的诊断意义

发布时间：2018-03-26 18:10

本文选题：抗survivin抗体　切入点：抗P53抗体　出处：《重庆医科大学》2011年硕士论文

【摘要】：目的: 喉癌是最常见的头颈部恶性肿瘤之一,能否早期诊断是提高喉癌5年生存率的最主要原因之一。因此目前,寻找理想的检测手段是喉癌研究领域的热点之一。本实验采用酶联免疫吸附双抗体夹心法(ELISA)检测喉癌患者外周血清中抗survivin抗体,抗p53抗体的阳性率,同时检测单纯手术治疗后一定时期内喉癌患者,正常对照组实验样本中抗survivin抗体,抗p53抗体的阳性率。通过比较各实验组阳性率的差异,探讨抗survivin抗体,抗p53抗体在喉癌早期诊断中的意义。分析抗survivin抗体,抗p53抗体与喉癌患者各临床病理参数,肿瘤分期之间的关系,探讨抗survivin抗体,抗p53抗体在判断手术疗效及预测复发中的意义。方法: 1.收集经病检证实为喉癌的所有住院患者(无其它原发性恶性肿瘤,术前未经放疗,化疗,且知情同意患者),包括术前组:31例未经治疗喉癌患者血清,平均年龄62.6岁;术后10天组:术前组患者术后第10天血清25例;术后17天组,术前组患者术后第17天血清23例。所有术后组样本均为手术切缘病理检查阴性。术后组患者也未经放疗,化疗。 2.酶联免疫吸附双抗体夹心法(ELISA)检测所有实验组样本中抗survivin抗体,抗p53抗体的OD值,以正常对照组血清OD均值加2倍标准差作为阴性血清的临界值,高于此值的即判为阳性。 3.数据分析:使用SPSS 17.0软件包,阳性率比较采用Fisher确切概率法进行检验,各组间OD值比较采有秩和检验,均以P0.05为差异有统计学意义。结果: 1.术前组中抗survivin抗体阳性率明显高于术后组及正常对照组(P0.05)。但与既往研究不同的是,我们的研究显示在喉癌患者不同分期中(I +II期,III + IV期)有明显统计学差异(P0.05)。 2.通过术前组中抗p53抗体阳性率,OD值与术后组及正常对照组比较发现,术前组中抗p53抗体阳性率及OD值明显高于术后组及正常对照组(P0.05)。同时在喉癌患者不同分期中(I +II期,III + IV期)有明显统计学差异(P0.05)。 3.抗survivin抗体,抗p53抗体联合检测时,其阳性率(67.7%)高于单一抗体在喉癌中的阳性率。结论: 1.虽然灵敏度偏低,但较高的特异度和阳性预测值,及术后喉癌患者血清中抗survivin抗体的低表达,术后组与正常对照之间的无差异性表达,使得抗survivin抗体具有成为一种新喉癌标记分子的可能性。 2.抗p53抗体在喉癌的诊断中有着非常重要的地位,具有成为一种新的喉癌标记分子的潜在可能;喉癌患者血清中抗p53抗体可能是一种判断疗效及筛选复发高危患者的有效指标。 3.抗体联合检测能够有效地提高喉癌患者的阳性检出率,在喉癌早期诊断中具有一定的应用价值,诊断意义高于单一抗体检测。术后抗survivin抗体及抗p53抗体的联合检测对于我们判断手术范围,为临床医师筛选术后复发的高危患者提供有益参考。
[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.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R739.65

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