【摘要】 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。更多还原

【Abstract】 OBJECTIVE This research explored the diagnostic value of detecting p53 autoantibodies in glioma patients’ serum and its correlation with future prognosis.METHODS In the tumor tissue and serum samples of 48 glioma patients,and 38 controls of this study,peptide microarray technology was used to detect the presence of p53 autoantibodies in response to the polypeptides,polymerase chain reaction(PCR)was used to detect the expression of p53 mRNA in organization,immunohistochemistry(IHC)was used to detect the expression of p53 protein in sample.RESULTS The signal noise ratio(SNR)of 48 serum samples was 19.05±22.21,which was significantly higher than the SNR of normal controls(7.08±5.75).The cut-off value for diagnosis by p53 autoantibody was 18.58.The area under the curve of ROC was0.63.Totally 18 of the 48 glioma patients were autoantibody positive,which represent 37.5% of the cases.Meanwhile,only one(2.6%)of the 38 controls was autoantibody positive.The sensitivity of glioma diagnosis by p53 autoantibody was 37.50%,while the specificity was 97.36%.Grades of glioma do not appear to be correlated with p53 autoantibody status.No obvious correlation was shown among p53 autoantibodies status,p53 mRNA level and p53 protein expression in immunohistochemistry.p53 autoantibody positive patients had statistically significant longer survival time than p53 autoantibody negative patients.CONCLUSIONS The ratio of positive to negative expression of serum p53 autoantibodies is lower in normal control.Glioma patients’ serum p53 autoantibodies evidently responded to polypeptides.Peptide microarray technology,which was used to detect serum p53 autoantibodies,has certain effects in diagnosis and prognosis of glioma patient.This finding has great value in postoperative follow-up and prognostic judgement of glioma patients.更多还原