The Values Of Anti-P53,NY-ESO-1 And MAPRE1 Tumor-associated Autoantibodies In The Early Diagnosis Of Colorectal Cancer

Background:Colorectal cancer(CRC)is a common malignant tumor of digestive system.In China,the incidence and mortality of colorectal cancer increase year by year.Early diagnosis and treatment of colorectal cancer can effectively improve the prognosis of patients and improve the life span of patients.Early screening is of great significance.Existing colonoscopy and other invasive tests are not suitable for early screening.In addition,the specificity and sensitivity of the currently used serological markers for clinical detection are poor.Finding non-invasive examination indicators or methods with high sensitivity and specificity is a new trend in the early diagnosis and screening of colorectal cancer.The immune system's response to tumors activated both cellular immunity and humoral immune responses.Tumor-associated autoantibodies are antibodies produced by the immune system against specific tumor antigens.Compared with traditional antigen markers,tumor autoantibodies are relatively stable in the serum,and can be detected in the early stages of the tumor.Therefore,tumor autoantibodies can be used for screening of early stages of cancer patients.Detection of a single tumor autoantibody has low sensitivity and high specificity.How to select multiple tumor autoantibody combinations to improve the diagnostic efficacy still requires further study.Objective:We measured the levels of autoantibodies(P53-AAbs?NY-ESO-1 AAbs,and MAPRE1 AAbs)in serum using the enzyme-linked immunosorbent assay(ELISA).We analyzed the diagnostic value of the single indicator or different combinations of above indicators in the early diagnosis of colorectal cancer.In this way,we tried to find a group of joint screening indicators with higher diagnostic efficacy providing the theory basis for early screening of colorectal cancer.Methods:Invesgating objects:67 colorectal cancer patients who were diagnosed in the Shandong provincial hospital from May to November 2017.There were 61 patients with tumor-like polyps and 40 healthy subjects joining in the trial.They were divided into malignant lesion group,benign lesion group and normal control group.Collected the fasting blood of the three groups.We stored the serum in a-80? refrigerator.Specimens are strictly avoiding repeated freezing and thawing.Methods:The levels of serum P53-AAbs,NY-ESO-1 AAbs,and MAPRE1 AAbs in the three groups were measured by ELISA.The electrochemiluminescence immunoassay(ECLIA)was also used.The serum CEA and CA-199 concentrations were measured in subjects.The maximal value of the Youden index was determined by the ROC curve as the cut-off value of the three tumor autoantibody markers,above which the value is positive.The normal reference range for the two tumor markers:CEA<10 ng/ml;CA-199<39 U/L.Above this range,it is judged as a positive result.Statistical Methods:Statistical data was processed using SPSS23.0.statistical charts were drawn by GraphPad Prism 5.0 software.Nonparametric tests(Kruskal-Wallis test)were used to compare the differences in anti-P53,NY-ESO-1,and MAPRE1 antibody levels between different groups.The ROC curve was used to analyze the diagnostic efficacy of the individual detection and joint detection of the five groups of indicators.Using the sensitivity,specificity,negative likelihood ratio,positive likelihood ratio,and other indicators to evaluate the diagnostic value of each indicator.The significance level of this study was 0.05,P<0.05 to determine the difference was statistically significant.Results:1.The serum levels of P53 AAbs(106.2ng/ml)in the malignant group and the serum P53 AAbs(88.07 ng/ml)in the benign group were higher than those in the healthy control group(53.71 ng/ml).The differences were statistically significant(P<0.05).The levels of NY-ESO-1 AAbs(14.19 ng/ml)in the malignant group and NY-ESO-1 AAbs(12.19 ng/ml)in the benign group were higher than those in the control group.7.78 ng/ml).The difference was statistically significant(P<0.01).The levels of serum MAPRE1 AAbs(262.80 pg/ml)and benign group serum MAPRE1 AAbs(268.25 pg/ml)were significantly higher than those of healthy group MAPRE1 AAbs(184.56 pg/ml).The difference of the level was statistically significant(P<0.01).2.In terms of diagnostic sensitivity,TAAbs' combination has a higher detective sensitivity(0.84)than that of three TAAbs alone.The sensitivity of the five indicators'combination was the highest(0.9).3.The diagnostic efficacy of the combination of three TAAbs(sensitivity 0.84,norden index 0.67,AUC value 0.88)was higher than that of CEA,CA199(sensitivity 0.54,norden index 0.44,AUC 0.72).The diagnostic value of the TAAbs was higher than that of CA199.The diagnostic value of P53 and NY-ESO-1 was higher than that of CEA.Conclusion:1.The serum levels of anti-P53,NY-ESO-1,and MAPRE1 autoantibodies in patients with colorectal cancer and colorectal benign tumors were significantly higher than those in normal individuals.The above three serum markers have an auxiliary diagnostic value for colorectal cancer patients.2.Anti-P53,NY-ESO-1,MAPRE1 autoantibodies have higher sensitivity and diagnostic efficiency compared with CEA,CA19-9 in the diagnosis of colorectal tumors.3.Novel tumor markers such as anti-P53,NY-ESO-1,and MAPRE1 autoantibodies are expected to become new clinical indicators for early screening and population screening of colorectal tumors.