SELDI技术筛选吉非替尼治疗非小细胞肺癌优势患者的相关性研究:耐药指纹峰簇与疗效的比较分析

Study on sifting the NSCLC patients suitable to receive gefitinib therapy with SELDI:the correlation between drug resistance fingerprint cluster and effect

目的:探索蛋白质指纹图谱峰型与吉非替尼治疗非小细胞肺癌(NSCLC)疗效相关性。方法:选择36名NSCLC患者,服用吉非替尼治疗前行SELDI(surface-enhaceed laser desorption/ionization,表面增强激光解析离子飞行时间质谱技术)检查,吉非替尼治疗时间达1个月以上,根据实体瘤疗效评价标准分成:有效组(CR+PR)、稳定(SD)、无效组(PD)。采用ProteinChip3.2.0软件和Biomarker Wizard3.1软件分析每个患者的质谱图(指纹图),对图谱中指纹峰型与吉非替尼治疗NSCLC疗效相关性进行分析。结果:①经SELDI检测,在M/Z8400H+～8900H+范围内形成明显峰簇。其中M/Z:(8690±30)H+的丰度>30%,同时在M/Z13000～14000范围内形成M/Z:(13754±50)H+和(13900±50)H+两个峰簇组成的明显峰簇,并且M/Z(6887±30)H+是较明显上调标志,可视为预测吉非替尼治疗NSCLC无效标识,为判定不宜服用吉非替尼治疗NSCLC的界定标准。②经SELDI检测,在M/Z:8400H+～8900H+范围内未形成明显峰簇。其中(8693±50)H+的丰度<15%,同时,在M/Z:(6887±30)H+处仅有指纹。可视为预测吉非替尼治疗有效指纹,为判断吉非替尼治疗NSCLC优势人群的界定指纹。结论:SELDI技术可以通过指纹描述来预测吉非替尼治疗NSCLC的疗效,判断服药优势人群和不宜服药人群。采用本方法可避免NSCLC患者盲目应用吉非替尼,可以使优势人群延长获益时间。

Objective：To research the correlation between the cluster of the fingerprint and therapeutic effect of treating NSCLC with gefitinib. Methods：36 NSCLC patients received SELDI （surface-enhanced laser desorption/ionization time-offlight mass spectrometry technique） inspection before treatment with gefitinib,who had observable tumor evaluation therapeutic effect,and took gefitinib for more than one month. According to the responseevaluation criteria in solid tumor,the patients were again divided into 3 groups：efficacy group （CR＋PR）,stable group （SD） and inefficacy group （PD）. The detected data were analyzed by ProteinChip 3.2.0 and Biomarker Wizard 3.1 Software,then analyzed the correlation between the cluster of the fingerprint and therapeutic effect of treating NSCLC with gefitinib. Results：①Inspected by SELDI,there were obvious cluster on the range of M/Z：8 400H^＋-8 90H^＋,among this,the fingerprint which the abundance of M/Z：（8 690±30）H^＋ 〉30%,formed obvious cluster consisted of M/Z：（13 754±50）H^＋ and （13 900±50）H^＋ on the range of M/Z：13 000H^＋-14 000H^＋,and M/Z：（6 887±30）H^＋ was the comparatively clear upside mark,may be regarded as the mark which points out that it will be invalid to cure NSCLC with gefitinib,the criterion to judge it is not suitable to take gefitinib to treat NSCLC. So,we don＇t propose these patients take gefitinib. ② Inspected by SELDI,there were not obviously cluster on the range of M/Z：8 400H^＋-8 900H^＋,among this,the fingerprint which the abundance of （8 693±50）H^＋〈15%,and the fingerprint only existed in M/Z：（6 887±30）H^＋,may be regarded as the valid fingerprint,it was the definition fingerprint to select the superior NSCLC patients with gefitinib,we proposed these patients to choose it firstly. Conclusion：SELDI can forecast the curative effect of gefitinib to NSCLC patients by fingerprint,and we can avoid use blindly of gefitinib and extend time benefit from gefitinib to advantage people.