Research On Serum Markers In The Early Diagnosis Of Esophageal Squamous Cell Carcinoma

Esophageal Squamous Cell Carcinoma (ESCC) mortality is ranking the 4th among all malignancies in China, threatening people’s life on this land. ESCC has insidious onset, rapid development and invasion, many are not diagnosed until advanced stage. The overall 5 year survival rate of ESCC is only 20%, while 70-80% if diagnosed at Stage I. Therefore, an effective method for early detection and diagnosis of ESCC is urgently needed, which can improve overall prognosis of this disease. Current screening methods, endoscopy, X-ray angiography, etc., have such shortcomings as invasiveness, insufficient sensitivity, operating complexity and long test period. Tumor marker, on the other hand, is a simple, non-invasive, economical, quick method, and it is suitable for large population screening. This study is aimed at finding an ideal panel of serum tumor markers for early diagnosis of ESCC in order to improve the early diagnosis as well as the overall survival rate.Serum samples from patients with different stages of ESCC are used as experimental group and samples from healthy people as control group.7 tumor markers, CEA, Cyfra21-1, SCC, DKK-1, MIC-1, HGF and LY6K, are involved in the small-sample pre-test.50 patient samples are tested to investigate whether these markers can distinguish ESCC from healthy controls. As a result, CEA, Cyfra21-1, SCC and MIC-1 show better potential in early diagnosis of ESCC, so these 4 markers are involved in the further investigation of larger population. In our further study,196 patient samples are utilized for combination analysis. Final result shows that combination of these 4 tumor markers has a sensitivity, specificity and accuracy of 75.0%,65.8% and 70.4%, better than any of these markers alone in diagnosing ESCC. Meanwhile, we also investigated the autoantibody of P53 in the ESCC early detection. After exploration of different experimental conditions, a procedure of autoantibody detection was established. Small-sample test (n = 25) shows great potential of P53 antibody in early diagnosis of ESCC.In conclusion, through study of 7 tumor markers in a small group and further test in a larger population, a panel of 4 markers, CEA + Cyfra21-1 + SCC + MIC-1, is established for ESCC early diagnosis, which is of higher diagnosis efficacy than those in clinical use. This new panel is of impressive prospect in future clinical application.