肾母细胞瘤血清蛋白质标记物检测与应用研究

The detectation of serum protein biomarkers of nephroblastoma and it＇s clinic value

目的筛选。肾母细胞瘤患儿特异性血清蛋白质标记物，并建立其临床分期模型与CT分期进行对照分析，评价其临床应用价值。方法应用SELDI-TOF-MS技术检测80例血清标本（术前肾母细胞瘤30例，其它恶性肿瘤30例，正常儿童20例），用ZUCI-Protein Chip Data Analyze System分析软件进行数据处理，结合支持向量机（support vector machine，SVM）建立。肾母细胞瘤临床分期模型。结果筛选出2个m／z位于4153．9和3257．6的蛋白质标记物，区分肾母细胞瘤Ⅲ和Ⅳ期与。肾母细胞瘤Ⅰ和Ⅱ期蛋白质谱差异表达模型的敏感性为83．33％，特异性为93．75％；区分。肾母细胞瘤与正常儿童，腹腔实体肿瘤及。肾脏其它恶性肿瘤的特异性是100．00％，敏感性是100．00％，80．00％，100．00％；临床分期模型可以特异性将各期区分开来，其特异性及敏感性均为100．00％；通过。肾母细胞瘤早期诊断模型中的2个m／z（6984．4，6455．5）血清标记物分析得知其各期情况如下：Ⅳ期相对于Ⅲ期低表达；Ⅲ期相对于Ⅱ期低表达；Ⅱ期相对于Ⅰ期低表达；Ⅰ期相对于正常儿童低表达；后者相对高表达；临床分期越晚m／z强度就越低表达。蛋白芯片分期准确性与病理基本一致，达到100．00％，在分期定性问题上优于CT（Ⅰ期100．00％，Ⅱ期85．00％，Ⅲ期85．00％，Ⅳ期75．00％）。结论用SELDI—TOF—MS结合SVM建立的。肾母细胞瘤临床分期模型可弥补CT在肾母细胞瘤分期定性上的不足。

Objective To investigate the different values of specific serum protein biomarkers and CT scan in the tumor stage in nephroblastoma. Methods Eighty serum samples （including 30 preoperative nephroblastomas, 30 other malignant tumors, 20 healthy children） were detected by SELDI -TOF -MS. The protein fingerprint data were analyzed by ZUCI -Protein Chip Data Analyze System. SVM was used to establish the nephroblastoma clinical staging pattern. The tumor stage according to the manifestation of CT scan in these tumors was also recorded. Results Two protein biomarkers were found （m/z ratio： 4 153.9,3 257.6 ）. These two markers separated nephroblastoma Ⅲ ＋ Ⅳfrom Ⅰ ＋ Ⅱwith sensitivity of 83.33%, specificity of 93.75%, and serparated nephroblastoma from healthy children,abdominal solid tumor and renal malignant tumor with specificity of 100.00% and sensitivity of 100.00%, 80.00%, 100.00% respectively. The accuracy of staging was 100.00% compared with the pathological diagnosis using these clinical staging system, which was superior to the accuracy of tumor stage by CT scan （ stage Ⅰ 100.00% , stage Ⅱ85.00% , stage Ⅲ 85.00% , stage Ⅳ75% ）. Conclusion The specific serum protein markers can give more information to identify nephroblastoma＇ s clinical stage, and formulate reasonable treatment plan.