科研：牛啤，CT发现肺癌之前5年，自身抗体即可检测到肺癌
很多科研论文的结论，非常的牛啤！很多时候我感觉就像是科幻小说。
最近看到一些研究，在CT发现肺癌之前5年，自身抗体就可以检测到肺癌！我都想去检查了。只是为什么这些方法不上市？
国内有文献提到，在CT发现癌症之前5年，肿瘤自身抗体即可早期发现肿瘤。这篇文章的观点引自2008年英国诺丁汉大学乳腺外科分会的学者发表在《Thorax》的论文《Autoantibodies in lung cancer: possibilities for early detection and subsequent cure》，然而这篇文章不是研究这个问题的，这篇文章只是引用了其他文章的观点。
Chapman CJ, Murray A, McElveen JE, et al. Autoantibodies in lung cancer: possibilities for early detection and subsequent cure. Thorax. 2008 Mar;63(3):228-33.
论文摘要！
Background: People with lung cancer usually present at a late stage in the course of their disease when their chances of long-term survival are low. At present there is little to offer for early diagnosis, even in those at high risk of developing the disease. Autoantibodies have been shown to be present in the circulation of people with various forms of solid tumour before cancer-associated antigens can be detected, and these molecules can be measured up to 5 years before symptomatic disease.
Objective: To assess the potential of a panel of tumour-associated autoantibody profiles as an aid to other lung cancer screening modalities.
Methods: Plasma from normal controls (n = 50), patients with non-small cell lung cancer (n = 82) and patients with small cell lung cancer (n = 22) were investigated for the presence of autoantibodies to p53, c-myc, HER2, NY-ESO-1, CAGE, MUC1 and GBU4-5 by enzyme-linked immunosorbent assay.
Results: Raised levels of autoantibodies were seen to at least 1/7 antigens in 76% of all the patients with lung cancer plasma tested, and 89% of node-negative patients, with a specificity of 92%. There was no significant difference between the detection rates in the lung cancer subgroups, although more patients with squamous cell carcinomas (92%) could be identified.
Conclusion: Measurement of an autoantibody response to one or more tumour-associated antigens in an optimised panel assay may provide a sensitive and specific blood test to aid the early detection of lung cancer.
百度翻译。
背景：肺癌患者通常出现在疾病晚期，长期存活的机会很低。目前，即使是在那些高危人群中，也没有什么可供早期诊断的。在检测到与癌症相关的抗原之前，已有证据表明自身抗体存在于患有各种形式实体瘤的人的循环中，并且这些分子可以在症状性疾病出现前5年内进行测量。
目的：评估一组肿瘤相关自身抗体谱对其他肺癌筛查模式的潜在帮助。
方法：采用酶联免疫吸附试验检测正常对照组（n=50）、非小细胞肺癌患者（n=82）和小细胞肺癌患者（n=22）血浆中p53、c-myc、HER2、NY-ESO-1、CAGE、MUC1和GBU4-5自身抗体的存在。
结果：76%的肺癌患者血浆检测到至少1/7抗原的自身抗体水平升高，89%的淋巴结阴性患者检测到至少1/7抗原的自身抗体水平升高，特异性为92%。虽然肺鳞癌患者亚组间的检出率（92%）无显著差异。
结论：在优化的群体分析中测量对一种或多种肿瘤相关抗原的自身抗体反应可提供敏感和特异的血液检测，以帮助早期发现肺癌。
然后，我把全文下载下来！
查到全文，我发现这篇文章也是引用别人的观点！（哎，没办法呀，不知道哪个机器人规定的，参考文献最好是近5年的，其实很多文章，最新的不一定是最好的）。
原来原始数据来自于《Journal Of Thoracic Oncology》（影响因子15）的一篇文章。2006年，美国学者对梅奥诊所CT筛查试验的102个样本（6个现患肺癌样本，40个是在CT诊断肺癌前1~5年提取的样本，56个风险匹配对照组样本）进行肿瘤自身抗体检测；对于6个现患肺癌样本，肿瘤自身抗体全部预测到肺癌；对于40个在CT诊断肺癌前1~5年提取的样本，肿瘤自身抗体预测到肺癌的有32例（80%），提示在CT发现肺癌之前5年，肿瘤自身抗体就可以早期发现肺癌。
注意，是2006年！
Zhong L, Coe SP, Stromberg AJ, Khattar NH, Jett JR, Hirschowitz EA. Profiling tumor-associated antibodies for early detection of non-small cell lung cancer. J Thorac Oncol. 2006 Jul;1(6):513-9.
摘要。
Background: A blood test for non-small cell lung cancer (NSCLC) may be a valuable tool for use in a comprehensive lung cancer screening strategy. Here we report the potential of autoantibody profiling to detect early-stage and occult NSCLC.
Methods: T7-phage NSCLC cDNA libraries were screened with patient plasma to identify phage-expressed proteins recognized by tumor-associated antibodies. Two hundred twelve immunogenic phage-expressed proteins, identified from 4000 clones, were statistically ranked for their individual reactivity with 23 stage I cancer patient and 23 risk-matched control samples. All 46 samples were used as a training set to define a combination of markers that were best able to distinguish patient from control samples; this set of classifiers was then examined using leave-one-out cross-validation. Markers were then used to predict probability of disease in 102 samples from the Mayo Clinic CT Screening Trial (six prevalence cancer samples, 40 drawn 1 to 5 years before diagnosis, and 56 risk-matched controls).
Results: Measurements of the five most predictive antibody markers in 46 cases and controls were combined in a logistic regression model that yielded area under the receiver operating characteristics curve of 0.99; leave-one-out validation achieved 91.3% sensitivity and 91.3% specificity. In testing this marker set with samples from the Mayo Clinic Lung Screening Trial, we correctly predicted six of six prevalence cancers, 32 of 40 cancers from samples drawn 1 to 5 years before radiographic detection on incidence screening, and 49 of 56 risk-matched controls.
Conclusions: Antibody profiling may be a useful tool for early detection of NSCLC.
百度翻译：供参考，翻译的惨不忍睹。
背景：非小细胞肺癌（NSCLC）的血液检测可能是综合肺癌筛查策略中有价值的工具。在此，我们报告了自身抗体谱检测早期和隐匿性NSCLC的潜力。
方法：用患者血浆筛选T7噬菌体非小细胞肺癌cDNA文库，鉴定肿瘤相关抗体识别的噬菌体表达蛋白。从4000个克隆中鉴定出212个免疫原性噬菌体表达蛋白，对其与23个I期癌症患者和23个风险匹配对照样本的个体反应性进行了统计排序。所有46个样本都被用作训练集，以确定最能区分患者和对照样本的标记组合；然后使用遗漏交叉验证检查这组分类器。然后，在梅奥临床CT筛查试验的102个样本中使用标记物预测疾病发生的概率（6个患病率癌症样本，40个在诊断前1至5年提取，56个风险匹配对照）。
结果：46例患者和对照组中五种最具预测性的抗体标记物的测量结合在一个logistic回归模型中，得出受试者操作特征曲线下的面积为0.99；剔除一项验证的敏感性和特异性分别为91.3%和91.3%。在使用梅奥诊所肺筛查试验的样本测试该标记集时，我们正确预测了6种流行性癌症中的6种，在发病率筛查的放射检测前1至5年抽取的样本中的40种癌症中的32种，以及56种风险匹配对照中的49种。
结论：抗体谱分析可作为非小细胞肺癌早期诊断的有用工具。
2006年，国外学者研究显示，对于40个在CT诊断肺癌前1~5年提取的样本，肿瘤自身抗体预测到肺癌的有32例（80%），提示在CT发现肺癌之前5年，肿瘤自身抗体就可以早期发现肺癌。
这么多年过去了，为什么不推广肿瘤自身抗体检测？这样可以在CT显示不了肺癌之前发现肺癌，可以早期治疗，不是，是极早期治疗。
要是有经费，好想做这方面的研究！
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陈翔六点半：老板中的标杆，行业中的翘楚！