SELDI-TOF-MS技术在肝癌诊断和介入治疗评价中的价值

Application of surfaceenhanced laser desorption ionization time-of-flight mass spectrometry to the diagnosis and evaluation of interventional effect in patients with hepatocellular carcinoma

目的:建立肝癌血清学诊断模型,探讨评估SELDI-TOF-MS技术在肝癌诊断和介入治疗评价中的价值.方法:用弱阳离子交换芯片(CM10芯片)和表面增强激光解吸电离飞行时间质谱仪(surface-enhanced laser desorption ionization time-of-flight mass spectrometry,SELDI-TOF-MS)技术,测定60例肝癌患者和60例正常对照者的血清蛋白质指纹图谱,应用BiomarkerWizard统计软件比较肝癌组和正常对照组血清蛋白质表达的差异性,采用Biomarker Pattern软件分析数据建立肝癌诊断模型,比较介入治疗前后血清蛋白质指纹图谱的差异性.结果:在质荷比(M/Z)为2000-10000范围内,和正常血清比较,肝癌的差异峰有3个(M/Z为4182Da、5710Da、6992Da;P<0.01),4182Da和5710Da下调,6992Da上调.用这3个差异蛋白峰建立肝癌诊断模型,诊断肝癌的灵敏度为93.3%(28/30),特异度为90.0%(27/30),正确率为91.7%(55/60),约登指数为0.833.差异蛋白峰(M/Z4182Da)在介入术后1mo明显上调(P<0.05).结论:应用SELDI-TOF-MS技术进行肝癌血清蛋白质指纹图谱分析,建立肝癌诊断树模型,对肝癌的诊断有一定的价值;筛选出的差异蛋白峰对肝癌的介入治疗评估有一定的应用价值.

AIM：To establish a serum protein pattern model for diagnosing hepatocellular carcinoma（HCC） by using the surface-enhanced laser desorption ionization time-of-fligh mass spectrometry（SEL-DI-TOF-MS）,and to evaluate the value of this model in predicting the effect of interventional treatment for HCC.METHODS：Serum samples collected from patients with HCC（n = 60） and healthy people（n = 60） were used for SELDI-TOF-MS on CM10 chips.The proteomic spectra were analyzed by using the Biomarker Wizard software.The diagnosis model was established by using the Biomarker Pattern software.RESULTS：Three significantly different protein peaks were found in serum samples between HCC patients and healthy controls.A protein peak at 6 992 Da showed higher expression and the other two protein peaks（4 182 Da,5 710 Da） showed lower expression in HCC patients than in healthy people.The diagnostic model containing these three candidate biomarkers could distinguish patients with HCC from healthy controls with a sensitivity of 93.3%（28/30）,a specificity of 90.0%（27/30）,an accuracy of 91.7%（55/60）,and a Youden index value of 0.833.The protein peak at 4 182 Da was significantly decreased one month after interventional treatment in HCC patients（P 0.05）.CONCLUSION：The diagnostic model developed by using SELDI-TOF-MS allows efficiently identifying patients with HCC and may play a valuable role in the diagnosis of HCC.The protein peak at 4 182 Da is helpful for the evaluation of interventional curative effect in HCC patients.