原发性肝细胞癌患者血清抗p53抗体的检测及意义探讨

目的 研究抗p53抗体检测以及与甲胎蛋白(AFP)联合检测对原发性肝细胞癌(HCC)诊断的效能。 方法 分别采用ELISA法与电化学发光法检测50例HCC、50例肝脏良性病变(LBL)、50例健康对照(HC)患者的血清抗p53抗体与AFP。 结果 HCC组血清抗p53抗体的水平和阳性率均明显高于LBL组(P<0.05)和HC组(P<0.01)。抗p53抗体对HCC的敏感性为36.0%,特异性为91.0%,ROC曲线下面积(AUC)为0.630(95% CI 0.547～0.707); AFP对HCC的敏感性为54.0%,特异性为83.0%,AUC为0.685(95%CI 0.604～0.758); 抗p53抗体与AFP联合检测可将对HCC敏感性提高至76.0%(特异性80.0%),AUC提高至0.770(95% CI 0.694～0.835)。 结论 抗p53抗体对HCC具有理想诊断价值; 抗p53抗体与AFP联合检测有助于提高对HCC的诊断效能(在保证特异性的前提下,提高敏感性)。

The Retection and Significance of Serum Anti-p53 Antibody for The Patients with Hepatocellular Carcinoma

Objective To study the diagnostic performances of serum anti-p53 antibody(anti-p53)detection as well as combined detection of serum anti-p53 with(AFP)for hepatocellular carcinoma(HCC). Methods Serum anti-p53 and AFP of 50 patients with HCC, 50 patients with liver benign lesion(LBL)and 50 healthy controls(HC)were detected by enzyme linked immunosorbent assay(ELISA)and electrochemiluminescence immunoassay(ECL), respectively. Results The level and positive rate of serum anti-p53 in HCC group were significantly higher than that in LBL group(P<0.05)and HC group(P<0.01). The sensitivity, specificity and area under ROC curve(AUC)of serum anti-p53 for HCC were 36.0%, 91.0% and 0.630(95%CI 0.547-0.707), respectively. The sensitivity, specificity and AUC of serum AFP for HCC were 54.0%, 83.0% and 0.685(95%CI 0.604-0.758), respectively. The sensitivity and AUC of combined detection of anti-p53 with AFP for HCC was improved to 76.0%(specificity 80.0%)and 0.770(95%CI 0.694-0.835), respectively. Conclusions Anti-p53 has an ideal diagnostic value for HCC. The combined detection of anti-p53 with AFP might contribute to the marked improvement of diagnostic performance for HCC, with the evidence of improved sensitivity and enough high specificity for HCC.