Peng Yu-Hui, Xu Yi-Wei, Huang Li-Sheng, Zhai Tian-Tian, Dai Li-Hua, Qiu Si-Qi, Yang Yu-Su, Chen Wei-Zheng, Zhang Li-Qun, Li En-Min, Xu Li-Yan
Department of Clinical Laboratory, the Cancer Hospital of Shantou University Medical College, Guangdong, China. The Key Laboratory of Molecular Biology for High Cancer Incidence Coastal Chaoshan Area, Shantou University Medical College, Guangdong, China.
Department of Clinical Laboratory, the Cancer Hospital of Shantou University Medical College, Guangdong, China. The Key Laboratory of Molecular Biology for High Cancer Incidence Coastal Chaoshan Area, Shantou University Medical College, Guangdong, China. Institute of Oncologic Pathology, Shantou University Medical College, Guangdong, China.
Cancer Prev Res (Phila). 2015 Aug;8(8):729-36. doi: 10.1158/1940-6207.CAPR-14-0397. Epub 2015 May 19.
Nasopharyngeal carcinoma (NPC) is prevalent in Southern China and Southeast Asia, and autoantibody signatures may improve early detection of NPC. In this study, serum levels of autoantibodies against a panel of six tumor-associated antigens (p53, NY-ESO-1, MMP-7, Hsp70, Prx VI, and Bmi-1) and Epstein-Barr virus capsid antigen-IgA (VCA-IgA) were tested by enzyme-linked immunosorbent assay in a training set (220 NPC patients and 150 controls) and validated in a validation set (90 NPC patients and 68 controls). We used receiver-operating characteristics (ROC) to calculate diagnostic accuracy. ROC curves showed that use of these 6 autoantibody assays provided an area under curve (AUC) of 0.855 [95% confidence interval (CI), 0.818-0.892], 68.2% sensitivity, and 90.0% specificity in the training set and an AUC of 0.873 (95% CI, 0.821-0.925), 62.2% sensitivity, and 91.2% specificity in the validation set. Moreover, the autoantibody panel maintained diagnostic accuracy for VCA-IgA-negative NPC patients [0.854 (0.809-0.899), 67.8%, and 90.0% in the training set; 0.879 (0.815-0.942), 67.4%, and 91.2% in the validation set]. Importantly, combination of the autoantibody panel and VCA-IgA improved diagnostic accuracy for NPC versus controls compared with the autoantibody panel alone [0.911 (0.881-0.940), 81.4%, and 90.0% in the training set; 0.919 (0.878-0.959), 78.9%, and 91.2% in the validation set), as well as for early-stage NPC (0.944 (0.894-0.994), 87.9%, and 94.0% in the training set; 0.922 (0.808-1.000), 80.0%, and 92.6% in the validation set]. These results reveal autoantibody signatures in an optimized panel that could improve the identification of VCA-IgA-negative NPC patients, may aid screening and diagnosis of NPC, especially when combined with VCA-IgA.
鼻咽癌（NPC）在中国南方和东南亚地区较为常见，自身抗体特征可能有助于鼻咽癌的早期检测。在本研究中，通过酶联免疫吸附测定法检测了一组六种肿瘤相关抗原（p53、NY-ESO-1、MMP-7、Hsp70、Prx VI和Bmi-1）的自身抗体血清水平以及爱泼斯坦-巴尔病毒衣壳抗原IgA（VCA-IgA），检测对象为一个训练集（220例鼻咽癌患者和150例对照），并在一个验证集（90例鼻咽癌患者和68例对照）中进行了验证。我们使用受试者操作特征（ROC）来计算诊断准确性。ROC曲线显示，在训练集中，使用这6种自身抗体检测方法得到的曲线下面积（AUC）为0.855 [95%置信区间（CI），0.818 - 0.892]，灵敏度为68.2%，特异性为90.0%；在验证集中，AUC为0.873（95% CI，0.821 - 0.925），灵敏度为62.2%，特异性为91.2%。此外，该自身抗体组合对VCA-IgA阴性的鼻咽癌患者也保持了诊断准确性[训练集中为0.854（0.809 - 0.899），67.8%，90.0%；验证集中为0.879（0.815 - 0.942），67.4%，91.2%]。重要的是，与单独使用自身抗体组合相比，自身抗体组合与VCA-IgA联合使用提高了对鼻咽癌与对照的诊断准确性[训练集中为0.911（0.881 - 0.940），81.4%，90.0%；验证集中为0.919（0.878 - 0.959），78.9%，91.2%]，对早期鼻咽癌也是如此（训练集中为0.944（0.894 - 0.994），87.9%，94.0%；验证集中为0.922（0.808 - 1.000），80.0%，92.6%）。这些结果揭示了优化组合中的自身抗体特征，其可以改善对VCA-IgA阴性鼻咽癌患者的识别，可能有助于鼻咽癌的筛查和诊断，特别是与VCA-IgA联合使用时。
