血清蛋白质指纹谱对结直肠癌的鉴别诊断价值研究

Significance of serum protein fingerprinting for differential diagnosis of colorectal cancer

目的探讨应用血清蛋白质指纹谱鉴别结直肠癌与其他常见恶性肿瘤的效能。方法应用表面增强激光解吸离子化飞行时间质谱(SELDI-TOF-MS)技术检测58例结直肠癌、30例结直肠良性疾病、90例其他恶性肿瘤(乳腺癌、胃癌、食管癌、肝癌、肺癌及肾癌各15例)患者及57例正常人的血清蛋白质指纹谱,建立结直肠癌鉴别诊断最优分类树模型。再从同期住院或健康体检人群中随机抽取以上诸病种及正常人各10例组成测试组,对鉴别诊断模型进行盲法验证。结果成功建立了由16种不同M/Z蛋白组成的结直肠癌鉴别诊断模型,该模型在测试模式下对结直肠癌的鉴别诊断准确率为83.8%,敏感度和总特异度分别为86.2%、83.1%,盲法验证总准确率为74.4%。结论应用血清蛋白质指纹谱技术建立的结直肠癌鉴别诊断模型具有较高的敏感度与特异度。

Objective To investigate the efficacy of serum protein fingerprinting on differential diagnosing colorectal cancer from other malignant tumors.MethodsThe serum protein fingerprinting of 58 patients of colorectal cancer,30 of colorectal benign diseases,90 of other malignant tumors （breast,gastric,esophagus,liver,lung and kidney cancer,15 cases each）,and 57 healthy subjects were read by surface-enhanced laser desorption/ionization-time of flight-mass spectrometry （SELDI-TOF-MS）,and the optimum classification tree model was developed for differential diagnosis of colorectal cancer.Ten patients of each disease mentioned above and 10 healthy subjects,randomly selected at the same period,were assigned as test set for blind testing of the model.ResultsThe classification tree model for differential diagnosis of colorectal cancer was successfully established.The model included 16 kinds of proteins with different M/Z,with accuracy of 83.8%,sensitivity of 86.2% and specificity of 83.1%,respectively,in test mode.The total accuracy for prediction was 74.4% in blind testing.ConclusionThe model for differential diagnosis of colorectal cancer established by serum protein fingerprinting has a high sensitivity and specificity.