血清蛋白质谱检测在子宫颈癌手术前后的临床应用价值初步分析

Clinical significance of serum proteomic profiling before and after cervical cancer surgery

目的初步探讨血清蛋白质谱在宫颈癌患者手术前后检测的临床应用价值。方法采用弱阳离子交换型（WCX）纳米磁珠结合基质辅助激光解吸电离飞行时间质谱（MALDI—TOF-MS）技术检测54例宫颈癌患者手术前后的血清样本与53例健康志愿者的血清样本。采用Biomarker Wizard软件分析蛋白质谱。结果宫颈癌患者手术前后血清蛋白质，在质荷比1500～50000范围内，有22个不同质荷比的蛋白质的相对含量有明显差异（P〈0．01）。其中，宫颈癌患者术前血清中质荷比为3981、4290、28066的蛋白质的相对含量为（1．51±1．78）％、（2．70±2．19）％、（1．99±1．70）％，高于健康人的（0．83±0．38）％、（1．72±0．91）％、（0．92±0．95）％，分别比较，差异均有统计学意义（P〈0．01）；但在术后均显著降低，分别为（0．59±0．45）％、（1．01±0．64）％、（0．54±0．37）％，分别与术前比较，差异均有统计学意义（P〈0．01）。而宫颈癌患者术前血清中质荷比为11487、11529、11678的蛋白质的相对含量为（0．38±1．41）％、（0．16±0．46）％、（1．02±1．67）％，术后升高为（2．74±3．67）％、（2．00±1．76）％、（7．71±9．46）％，分别比较，差异均有统计学意义（P〈0．01）。结论血清蛋白质谱可以筛选出宫颈癌手术前后相对含量有差异的蛋白质。质荷比为3981、4290、28066的蛋白质可能与肿瘤负荷相关，质荷比为11487、11529、11678的蛋白质可能与手术应激相关。

Objective To investigate the value of serum proteomic profiling in cervical cancer detected pre-surgery and post-surgery. Methods Magnetic bead and matrix-assisted laser desorption/ ionization-time of flight-mass spectrometry （MALDI-TOF-MS） were used to detect the serum samples from 54 cases with cervical cancer before and after surgery and 53 serum samples from healthy women. The results of spectra were analyzed by Biomarker Wizard software. Results Significant variation of proteomic profiling between pre-surgery and post-surgery were analyzed. There were 22 proteins with different mass/charge （M/Z） values significantly different （P 〈 0. 01 ） at the M/Z value range from 1500 to 50 000, among of which relative content of proteins with M/Z 3981,4290, and 28 066 in pre-surgery cervical cancer patients were higher than those in health women [（1.51 ±1.78）% vs. （0.83 ±0.38）%, （2.70 ±2. 19）% vs. （ 1.72 ± 0. 91 ） %, （ 1.99 ± 1.70） % vs. （ 0. 92 ±0. 95） % ; P 〈 0. 01 ], while in the post-surgery patients, relative content of these three proteins significantly decreased to （0. 59 ±0.45 ） %, （ 1.01 ± 0. 64 ） %, （0. 54 ±0. 37 ） % , respectively. But the relative content of another three proteins with M/Z 11 487, 11 529, and 11 678 were significantly increased in post-surgery patients [ （0. 38 ±1.41 ） % vs. （2.74 ±3.67）%, （0.16±0.46）% vs. （2.00±1.76）%, （1.02±1.67）% vs. （7.71 ±9.46）%; P〈0.01]. Conclusion Serum proteomic profiling could screen out the proteins which had significant variation between pre-surgery and post-surgery serum, of which with M/Z 3981,4290, and 28 066 may be related with tumor burden, while with M/Z 11 487, 11 529, and 11 678 may be response to surgical stress.