应用表面加强激光解吸电离-飞行时间-质谱技术检测结直肠癌肝转移

Application of SELDI-TOF-MS in detection of liver metastasis from colorectal cancer

目的寻找与结直肠癌肝转移相关的蛋白质，建立结直肠癌肝转移的血清蛋白质指纹图谱诊断预测模型。方法应用表面加强激光解吸电离-飞行时间-质谱（SELDI—TOF—MS）技术，对36例结直肠癌无肝转移患者和36例结直肠癌伴肝转移患者的术前空腹外周静脉血标本，进行蛋白质指纹图谱测定，运用Biomarker Wizard软件，建立结直肠癌肝转移的诊断预测模型。用44例结直肠癌患者和44例结直肠癌伴肝转移患者，对所建立的诊断预测模型进行盲法验证。结果比较36例结直肠癌无肝转移患者和36例结直肠癌伴肝转移患者的血清蛋白质，得到10个差异蛋白峰（P〈0．05），质荷比分别为2398、2814、4084、4289、4465、6422、6619、11482、11649和13714。若以P〈0．01为标准，则有3个蛋白质峰差异有统计学意义，质荷比分别为2398、2814和13714。建立终末节点数为9的诊断预测模型，其敏感性为91．7％，特异性为97．2％。验证结果显示，敏感性为75．0％，特异性为81．8％。结论运用SELDI—TOF—MS技术所建立的血清蛋白指纹图谱模型，在预测结直肠癌肝转移中具有非常高的敏感性与特异性，可望成为预测诊断工具。

Objective To establish a serum protein fingerprint model for prediction of liver metastasis from colorectal cancer by SELDI-TOF-MS analysis, and to determine the differentiatial proteins associated with the metastatic liver cancers. Methods Data were collected from the Department of General Surgery in Zhongshan Hospital. A group of patients with coloreetal cancer （ CRC ） without liver metastasis （n =36） and another group with liver metastasis （n = 36） were included in this study. Serum samples were collected from peripheral venous blood before operation. Special serum protein or peptide fingerprint was determined by surface-enhanced laser desorption/ionization time-of-flight mass spectrometry （SELDI-TOF- MS）. The obtained data were analyzed by Biomarker Wizard software to screen the serum protein markers discriminating colorectal cancer patients with and without liver metastasis. A serum protein fingerprint model was established. This model was blindly verified in of CRC patients with and 44 cases without liver metastasis. Results Comparing the characteristic proteins in those two groups of patients, 10 specific protein peaks were identified with statistical significance （ P 〈 0.05 ）. According to m/z growing from small to large,they were： 2398, 2814, 4084, 4289, 4465, 6422, 6619, 11 482, 11 649 and 13 714. The predictive model had a sensitivity of 91.7% and a specificity of 97.2%. The validation showed a sensitivity of 75.0% and a specificity of 81.8%. Conclusion A predictive model based on differentiatial serum protein fingerprint with high sensitivity and specificity has been successfully established. It should be a very useful tool in detection and diagnosis of liver metastasis in colorectal cancer patients.