论文部分内容阅读
目的脑胶质瘤目前尚缺乏血清学的指标用于早期诊断以及判断预后。本研究拟探索胶质瘤患者血清中p53自身抗体表达在胶质瘤诊断和预后判断中的价值。方法选取苏州大学附属第一医院2013-01-01-2014-12-30收治的48例脑胶质瘤患者的肿瘤组织和血清作为研究对象,选取同期38例正常人血清为对照。采用多肽微阵列纳米芯片技术检测患者血清中p53自身抗体对多肽的响应,聚合酶链反应(PCR)检测组织中p53mRNA的表达,免疫组织化学法检测组织中p53蛋白的表达水平。结果 48例胶质瘤血清样本中,p53自身抗体的信号噪声比(signal noise ratio,SNR)总值为19.05±22.21,高于正常人群的7.08±5.75。p53自身抗体的胶质瘤诊断cut-off值为18.58,ROC曲线下面积为0.63。48例患者中p53自身抗体阳性率37.5%,38名正常对照p53自身抗体阳性率2.6%。p53自身抗体对胶质瘤诊断的敏感性为37.50%,特异性为97.36%。p53自身抗体在不同级别的胶质瘤中无明显差异。p53自身抗体与p53mRNA水平以及免疫组化中的p53蛋白表达未见明显相关性。对48例胶质瘤患者进行随访发现,p53自身抗体阳性的患者较阴性的患者有较长的生存时间,差异有统计学意义,P<0.05。结论正常人血清p53自身抗体阳性率较低,而胶质瘤患者血清中p53自身抗体阳性率较高,且SNR值较高。多肽微阵列技术检测血清p53自身抗体在胶质瘤诊断有一定的作用。对于胶质瘤患者术后的随访以及预后判断具有较大的价值。
Objective Glioma is still lack of serological indicators for early diagnosis and prognosis. This study was to explore the value of serum p53 autoantibodies expression in the diagnosis and prognosis of gliomas. Methods Tumor tissue and serum from 48 patients with glioma who were admitted to the First Affiliated Hospital of Soochow University from January 2013 to January 2014 were enrolled as study subjects. 38 normal subjects were selected as the control. Peptide microarray was used to detect the level of p53 autoantibodies in serum of patients. Polymerase chain reaction (PCR) was used to detect the expression of p53 mRNA in tissues. The expression of p53 protein was detected by immunohistochemistry. Results The signal-to-noise ratio (SNR) of p53 autoantibodies was 19.05 ± 22.21 in 48 glioma serum samples, which was higher than the normal population of 7.08 ± 5.75. The diagnostic cut-off value of p53 autoantibodies was 18.58. The area under the ROC curve was 0.63. The positive rate of p53 autoantibodies was 37.5% in 48 cases and the positive rate of 38 autoantibodies in 38 normal controls was 2.6%. The sensitivity of p53 autoantibodies to the diagnosis of gliomas was 37.50% and the specificity was 97.36%. p53 autoantibodies in different grades of gliomas no significant difference. There was no significant correlation between p53 autoantibodies and p53 mRNA levels and p53 protein expression in immunohistochemistry. Follow-up of 48 patients with glioma found that p53 autoantibody-positive patients had longer survival time than negative patients, the difference was statistically significant, P <0.05. Conclusion The positive rate of p53 autoantibodies in normal people is low, but the positive rate of p53 autoantibodies in serum of patients with gliomas is higher, and the SNR value is higher. Peptide microarray detection of serum p53 autoantibodies in the diagnosis of gliomas have a role. For patients with glioma after follow-up and prognosis of great value.