微小染色体维持蛋白 2 在我国食管癌高危人群筛查中的潜在作用。
Potential role of minichromosome maintenance protein 2 as a screening biomarker in esophageal cancer high-risk population in China.
机构信息
Department of Pathology & Institute for Clinical Pathology, Shantou University Medical College, Shantou 515031, Guangdong Province, China.
出版信息
Hum Pathol. 2011 Jun;42(6):808-16. doi: 10.1016/j.humpath.2010.04.022. Epub 2011 Jan 15.
Minichromosome maintenance proteins are novel proliferative markers that have been proposed as diagnostic markers in many cancers. We evaluated the potential role of minichromosome maintenance protein 2 as a screening biomarker and compared it with proliferating cell nuclear antigen and Ki67 in a population survey of esophageal squamous cell carcinoma. A total of 299 esophageal samples from a high-risk region in China, including 171 from an endoscopy population survey, 30 from brushing cytology, and 98 from surgery and autopsy, underwent immunostaining with minichromosome maintenance protein 2, proliferating cell nuclear antigen, and Ki67 antibodies. Minichromosome maintenance protein 2 expression was confined to the proliferative compartment of normal and abnormal esophageal epithelium and particularly manifested in the surface layer of dysplasia and carcinoma in situ. The expression of proliferating cell nuclear antigen and Ki67 was positively correlated with that of minichromosome maintenance protein 2 (r(s) >0.39, P < .01); but their positive nuclei seldom reached the surface layer, and the labeling indices were significantly lower than those for minichromosome maintenance protein 2 in dysplasia (P < .05) and carcinoma in situ (P < .001). The sensitivity and specificity of minichromosome maintenance protein 2 in diagnosing dysplasia were 91.3% and 61.8%, respectively, higher than those for proliferating cell nuclear antigen (88.4% and 47.1%) and Ki67 (78.3% and 57.8%). Nine of 10 cancer and paracancerous surface-brushing samples expressed minichromosome maintenance protein 2, and the detection was higher than that for proliferating cell nuclear antigen (8/10 and 7/10) and Ki67 (7/10 and 7/10). However, none of 10 normal surface-brushing samples expressed the 3 markers. Minichromosome maintenance protein 2 is more sensitive and specific than proliferating cell nuclear antigen and Ki67 in indicating esophageal dysplasia. Minichromosome maintenance protein 2 immunostaining combined with surface brushing could be valuable in screening patients at high risk of cancer in mass surveys.
微染色体维持蛋白是新型增殖标志物，已被提议作为许多癌症的诊断标志物。我们评估了微染色体维持蛋白 2 作为筛查生物标志物的潜在作用，并将其与增殖细胞核抗原和 Ki67 在食管癌的人群调查中进行了比较。共对来自中国高危地区的 299 例食管样本进行了免疫染色，包括内镜人群调查的 171 例、刷检细胞学的 30 例和手术及尸检的 98 例，这些样本使用了微染色体维持蛋白 2、增殖细胞核抗原和 Ki67 抗体。微染色体维持蛋白 2 的表达局限于正常和异常食管上皮的增殖区，特别是在发育不良和原位癌的表面层中表达。增殖细胞核抗原和 Ki67 的表达与微染色体维持蛋白 2 的表达呈正相关（r(s)>0.39，P<.01）；但是它们的阳性核很少达到表面层，并且在发育不良（P<.05）和原位癌（P<.001）中标记指数明显低于微染色体维持蛋白 2。微染色体维持蛋白 2 诊断发育不良的敏感性和特异性分别为 91.3%和 61.8%，高于增殖细胞核抗原（88.4%和 47.1%）和 Ki67（78.3%和 57.8%）。10 例癌症和癌旁表面刷检样本中有 9 例表达微染色体维持蛋白 2，其检测结果高于增殖细胞核抗原（8/10 和 7/10）和 Ki67（7/10 和 7/10）。然而，10 例正常表面刷检样本均未表达这 3 种标志物。微染色体维持蛋白 2 在提示食管发育不良方面比增殖细胞核抗原和 Ki67 更敏感和特异。微染色体维持蛋白 2 免疫染色结合表面刷检可用于癌症高危人群的大规模筛查。
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