胃肠道癌危重患者预警蛋白质组指纹与生存关系的观察

Study on the survival of patients with gastrointestinal cancer versus the expression of LGT fingerprints

目的探讨危重患者预警蛋白质（LGT）多肽谱指纹的峰型和丰度对判断胃肠道癌患者病情发展及预后的意义。方法对接受表面增强激光解吸／电离飞行时间质谱（SELDI）技术检测的61例患者进行生存期与死亡时间的调查，并根据SELDI检测所获得的指纹图，以LGT指纹存在与否，分为无峰组、单峰组、双峰组、三峰及多峰组。采用多因素方差分析和COX风险回归模型分析比较四组中死亡风险最大的状态。结果胃肠道癌患者经SELDI技术检测所获取的指纹图中，LGT呈阴性表达者，死亡风险低于单、双峰组，远低于三峰和多峰组。LGT三峰和多峰组死亡风险远高于单、双峰组，差异有统计学意义（P〈0．05）。结论采用SELDI技术检测胃肠道癌患者的血清LGT，出现三峰和多峰表达，提示病情即将恶化，该指纹标识为LGT阳性指标；单、双峰为疑似指标；LGT指纹阴性表达者，近期预后良好，死亡风险极低。

Objective To demonstrate the result that progression of disease and prognosis of gastrointestinal cancer patients are correlated with the expression of the cluster and the abundance of lost goodwill target （LGT） fingerprint. Methods To research the period of survival and the time of death, 61 patients treated by SELDI （Surface enhanced laser desorption / ionization-time of flight-mass spectrometer） were involved in. According to the fingerprint spectrum obtained by SELDI and the appearance of fingerprints of LGT, these patients were divided into four groups namely non-peak, single-peak, double-peak, tri-peak and multi-peak groups. By means of Multi-factor analysis of variance and Cox regression analysis of risk, we compare four groups each other so as to find out one group in which patients have the greatest risk of death. Results Among the fingerprint spectrums of patients suffered from gastrointestinal cancer, which were obtained by SELDI, the patients with negative expression of LGT had low risk of death, which were lower than those of single-peak and double-peak groups, especially lower than those of tri-peak and multi-peak groups; the risk of death among the tri-peak and multi-peak groups were much higher than single-peak, the difference had statistical significance （P 〈0.05）, and the death rate is rather high. Conclusion Among the serums from cancer patients tested by SELDI, the expression of LGT with tri-peak and multi-peak suggested that patient＂ s state of illness is about to deteriorate. This kind of fingerprint spectrum can be regarded as positive indicators, and the negative expression of LGT suggested that patient will have a good prognosis with a very low risk of death in the near future.