Chapman C J, Murray A, McElveen J E, Sahin U, Luxemburger U, Türeci O, Wiewrodt R, Barnes A C, Robertson J F
Division of Breast Surgery, The University of Nottingham, Nottingham NG5 1PB, UK.
Thorax. 2008 Mar;63(3):228-33. doi: 10.1136/thx.2007.083592. Epub 2007 Oct 11.
People with lung cancer usually present at a late stage in the course of their disease when their chances of long-term survival are low. At present there is little to offer for early diagnosis, even in those at high risk of developing the disease. Autoantibodies have been shown to be present in the circulation of people with various forms of solid tumour before cancer-associated antigens can be detected, and these molecules can be measured up to 5 years before symptomatic disease.
To assess the potential of a panel of tumour-associated autoantibody profiles as an aid to other lung cancer screening modalities.
Plasma from normal controls (n = 50), patients with non-small cell lung cancer (n = 82) and patients with small cell lung cancer (n = 22) were investigated for the presence of autoantibodies to p53, c-myc, HER2, NY-ESO-1, CAGE, MUC1 and GBU4-5 by enzyme-linked immunosorbent assay.
Raised levels of autoantibodies were seen to at least 1/7 antigens in 76% of all the patients with lung cancer plasma tested, and 89% of node-negative patients, with a specificity of 92%. There was no significant difference between the detection rates in the lung cancer subgroups, although more patients with squamous cell carcinomas (92%) could be identified.
Measurement of an autoantibody response to one or more tumour-associated antigens in an optimised panel assay may provide a sensitive and specific blood test to aid the early detection of lung cancer.
肺癌患者通常在疾病晚期才被发现,此时其长期生存的机会很低。目前,即使对于肺癌高危人群,早期诊断的方法也很少。研究表明,在可检测到癌症相关抗原之前,多种实体瘤患者的循环中就已存在自身抗体,而且在出现症状性疾病前5年就可检测到这些分子。
评估一组肿瘤相关自身抗体谱作为其他肺癌筛查方法辅助手段的潜力。
采用酶联免疫吸附测定法,检测正常对照者(n = 50)、非小细胞肺癌患者(n = 82)和小细胞肺癌患者(n = 22)血浆中针对p53、c-myc、HER2、NY-ESO-1、CAGE、MUC1和GBU4-5的自身抗体。
在所有检测的肺癌患者血浆中,76%的患者至少有1/7种抗原的自身抗体水平升高,在无淋巴结转移的患者中这一比例为89%,特异性为92%。肺癌各亚组的检测率之间无显著差异,不过鳞状细胞癌患者的检测率更高(92%)。
在优化的组合检测中,检测针对一种或多种肿瘤相关抗原的自身抗体反应,可能会提供一种敏感且特异的血液检测方法,有助于肺癌的早期检测。