摘要
目的 研究抗转录中介因子1（TIF1）家族蛋白抗体谱与DM合并肿瘤的相关性,探讨联合检测血清抗TIF1抗体谱不同亚型（α/β/γ）在DM合并肿瘤诊断中的价值.方法 本研究共纳入DM患者156例,PM 55例,SLE 70例,RA60例,pSS 46例和SSc 14例,各类型肿瘤49例,健康对照40名.采用免疫沉淀非标记抗原法分别检测上述研究对象中血清抗TIF1-α,抗TIF1-β和TIF1-γ抗体的水平.采用方差分析、t检验,Mann-Wittney U检验、χ^2检验或Fisher确切概率法进行统计学分析,非参数法计算受试者工作特征曲线（ROC）下面积评价敏感性和特异性.结果 抗TIF1抗体在DM患者中的总阳性率为20.5％（32/156）,共有4种不同类型：单纯抗TIF1-γ抗体阳性占总阳性者的62.5％ （20/32）;单纯抗TIF1-α抗体阳性占12.5％（4/32）;抗TIF1-α抗体与抗TIF1-γ抗体同时阳性者占21.9％（7/32）;抗TIF1-β抗体与抗TIF1-γ抗体同时阳性者占3.1％（1/32）.PM中仅检测到抗TIF1-α抗体,阳性率为7.3％（4/55）,而PM合并肿瘤组该抗体阳性率为0.其余CTD组、普通肿瘤组及健康人血清未检测到抗TIF1抗体谱.抗TIF1-α抗体阳性诊断DM合并肿瘤的敏感性为42.9％,特异性为96.5％;抗TIF1-β抗体阳性诊断DM合并肿瘤的敏感性为0％,特异性为99.3％;抗TIF1-γ抗体阳性诊断DM合并肿瘤的敏感性为64.3％,特异性为86.6％;利用ROC曲线下面积对串联和并联检测3种抗体的方法用于诊断DM合并肿瘤的绩效进行评价,对应的曲线下面积分别为0.70,0.50,0.76,0.74和0.71.结论 联合检测抗TIF1家族蛋白抗体谱有助于提高DM合并肿瘤的诊断.
Objective To study the relationship between anti-transcription intermediary factor 1 family proteins （TIF1） autoantibodies profiles and cancer-associated dermatomyositis （CAM） and to define the diagnostic value of different subtypes of anti-TIF1 aotuantibodies for CAM.Methods The sera from 156 patients with dermatomyositis （DM）,55 with polymyositis （PM）,70 with systemic lupus erythematosus （SLE）,60 with rheumatoid arthritis （RA）,46 with primary Sj（o）gren syndrome （pSS）,14 with systemic sclerosis （SSc）,49 with kinds of malignancies and 40 healthy subjects were examined by immunoprecipitation assays followed by western blotting.Statistical analysis were performed using ANOVA,t test Mann-Wittney U and χ^2 test or Fisher exact test,nonparametric method was used to evaluate the sensitivity and specificity through calculating the area under the receiver operating characteristic curve （ROC）.Results In summary,32 of 156 sera from patients with DM （20.5%） were positive for at least one anti-TIF1 autoantibodies.There are four subtypes of anti-TIF1 autoantibodies profiles existed in patients with DM,including 4 patients with only positive anti-TIF1-α （12.5%）,20 with only positive anti-TIF1-γ （62.5%）,7 with both positive anti-TIF1-α and anti-TIF1-γ （21.9%） and 1 with both positive anti-TIF1-β and anti-TIF1-γ （3.1%）.However,only positive anti-TIF1-α （7.3%） was observed in 4 patients with PM.No patients with other CTDs as well as malignancy and healthy subjects were positive for these autoantibodies.The sensitivity and specificity of presence of anti-TIF1-α antibodies for the diagnosis of CAM were 42.9% and 96.5%,respectively and those of anti-TIF1-β antibodies were 0 and 99.3%,respectively and those of anti-TIF-1-γ antibodies were 64.3% and 86.6%,respectively.Application of areas of ROC to identify the best performance of test of anti-TIF1 antibodies profiles were 0.70,0.50,0.76,0.74 and 0.71,respectively.Conclusion Joint detection of antiTIF1 autoanti
出处
《中华风湿病学杂志》
CAS
CSCD
北大核心
2014年第6期369-374,共6页
Chinese Journal of Rheumatology
基金
北京市科委资助项目（Z111107058811084）
