Background & objective: Evaluation of the quantitative distribution of interphase AgNOR (argyrophilic nucleolar organizer regions) has been widely used for diagnostic and prognostic purposes of tumor. It has been proven by tumor immunology that tumor can induce host immunosuppression. T lymphocyte immune activity can be reflected by detecting AgNOR expression in nucleolar organizer regions. There are few reports about AgNOR expression in peripheral blood T lymphocyte of the patients with esophageal carcinoma. In this investigation, AgNOR expression in peripheral blood T lymphocyte was systematically evaluated in a serial of patients with esophageal carcinomas to determine its value in diagnosis of the patients.
Methods: AgNOR expression in peripheral blood T lymphocyte of 276 patients with esophageal carcinoma and 75 healthy controls were measured by microphotometry with the technique of silver stain. At the same time, carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC) and tumor specific growth factor (TSGF) were also measured by microparticle enzyme immune analysis, bio-antibody sandwich, and chemo-chromatometry.
Results: (1) AgNOR expression in peripheral blood T lymphocyte of the patients with esophageal carcinoma (5.64+/-0.89) were much lower than that of control group (7.07+/-0.81)(P=0.000). The positive rate, sensitivity, and specificity were 67.4%, 0.674, and 0.920, respectively. Youden index was 0.59 and the area under receiver operator characteristic (ROC) curve was 0.886. (2) The positive rate of AgNOR (67.4%) was higher than those of CEA (12.86%), SCC (15.04%), and TSGF (36.49%) in patients with esophageal carcinoma (P< 0.001). There was no relationship between AgNOR expression and CEA, SCC, and TSGF (P>0.05). (3) AgNOR expression has a higher positive rate in patients with esophageal carcinoma than the combined positive rate of CEA, SCC, and TSGF (P = 0.018), but has a similar positive rate with those of AgNOR+CEA, AgNOR+SCC, or AgNOR+CEA+SCC, with no statistical difference (P >0.05). Combination of all these four indicators is much superior to determination of AgNOR expression alone (P=0.000), its sensitivity, Youden index, and the area under receiver operator characteristic curve were 0.875, 0.77, and 0.955, respectively.
Conclusions: There is notable immunosuppression in patient with esophageal carcinoma. Detecting AgNOR expression of peripheral blood T lymphocytes has value in cell immune function of esophageal carcinoma patients and suitable application value in screening and diagnosis of esophageal carcinoma patient. It is sophisticatal far screening method for esophageal carcinoma in combination with AgNOR SCC, CEA and TSGF detection.