结直肠癌与其他恶性肿瘤血清低分子差异蛋白的比较

Comparative analysis of differential serum low molecular weight proteins between colorectal cancer and other malignant tumors

目的:通过结直肠癌与其他常见恶性肿瘤血清低分子差异蛋白的分析,探讨其对结直肠癌的诊断特异性.方法:收集结直肠癌(68例)、其他恶性肿瘤(乳腺癌、胃癌、食管癌、肝癌、肺癌及肾癌各25例)血清标本共218份,应用表面增强激光解吸/电离-飞行时间-质谱检测其蛋白质指纹谱.用Biomarker Wizard软件分析结直肠癌与其他恶性肿瘤患者血清中的低分子差异蛋白后,分别作出受试者工作特征(ROC)诊断曲线.再选取ROC曲线下面积(AUC)>0.8的蛋白,建立Fisher判别模型.结果:结直肠癌与其他恶性肿瘤相比,血清中有12种蛋白相对高表达,102种蛋白相对低表达.ROC曲线显示,有75种蛋白AUC>0.5,其中8911、8919、8964、11726、14049、14139M/Z的蛋白AUC>0.8.用这6种蛋白建立的Fisher判别模型,鉴别结直肠癌的敏感性88.2%,特异性93.3%,准确率91.7%.结论:结直肠癌与其他恶性肿瘤相比,血清中存在明显差异表达的低分子蛋白,对结直肠癌具有诊断特异性,值得进一步研究.

AIM： To evaluate the diagnostic specificity differentially expressed serum low molecular proteins for colorectal cancer by comparative analysis between the patients with colorectal cancer and with other malignant tumors. METHODS： A total of 218 serum samples from patients with colorectal cancer （n = 68） and other malignant tumors （breast, gastric, esophagus, liver, lung and kidney, 25 cases each） were collected. Their serum protein fingerprinting was read by surface-enhanced laser desorption/ionization-time of flight-mass spectrometry （SELDI- TOF-MS）. Biomarker Wizard software was used to analyze the distinct proteins between colorectal cancer and other malignant tumors and to create receiver operating characteristic （ROC） curves. Then Fisher＇s discriminant model was established using the distinct proteins with the area under the curve （AUC） 〉 0.8. RESULTS： Relatively 12 proteins were highly expressed and 102 proteins were lowly expressed in the sera of colorectal cancer com- pared with that of the other malignant tumors. Of all the 75 proteins with AUC 〉 0.5 by ROC analysis, six proteins （AUC 〉 0.8） were selected to establish the Fisher＇s discriminant model. The accuracy of distinguishing colorectal cancer from other malignant tumors was 91.7%, and the sensitivity and specificity were 88.2% and 93.3%, respectively. CONCLUSION： The significantly differentially expressed serum low molecular proteins have a high diagnostic specificity for distinguishing colorectal cancer from other malignant tumors, which deserves further research.