原发性肝癌介入治疗围手术期不同中医证型的血清蛋白表达差异

Differentially Expressed Proteins in Serum among Different Chinese Medical Syndrome Types of Primary Liver Cancer in the Perioperative Period of Interventional Treatment

目的探讨原发性肝癌介入治疗围手术期不同中医证型的血清蛋白差异表达,并分析其意义。方法将154例原发性肝癌患者按中医辨证分为肝郁证(37例)、脾虚证(45例)、湿热证(18例)、血瘀证(28例)及阴虚证(26例),应用表面加强激光解析电离化飞行时间质谱法(surface enhanced laser desorption ionization time of flight mass spectrometry,SELDI-TOF-MS)分析其血清蛋白指纹图谱,并结合中医证候特点,探讨肝癌介入治疗围手术期不同中医证型的血清蛋白差异表达。结果介入前1周,M/Z为3392、4970、5911、6200、8575Da的血清蛋白峰在各证型间的表达比较,差异有统计学意义(P<0.05,P<0.01);上述5个差异蛋白峰同时出现于脾虚证和血瘀证中。介入后1周,阴虚证M/Z为8575Da的血清蛋白峰表达下调,差异有统计学意义(P<0.01)。结论肝癌介入治疗围手术期不同证型间出现血清差异蛋白质峰。

Objective To explore different expressions of serum proteins among different Chi- nese medical syndrome types of primary liver cancer （PLC） in the perioperative period of interventional treatment, and to explore its significance. Methods Totally 154 PLC patients were assigned to Gan de- pression syndrome （GDS, 37 cases）, Pi deficiency syndrome （PDS, 45 cases）, dampness heat syn- drome （DHS, 18 cases）, blood stasis syndrome （BSS, 28 cases）, and yin deficiency syndrome （YDS, 26 cases）. The mass spectra of serum proteins were analyzed by using surface enhanced laser desorp- tion ionization time of flight mass spectrometry （SELDI-TOF-MS）. By combining the features of Chinese medical syndromes, the different expressions of serum proteins among different Chinese medical syn- drome types of PLC in the perioperative period of interventional treatment were explored. Results One week before interventional treatment, there was statistical difference in the expression of serum protein peak with mass-to-charge ratio （M/Z） being 3 392, 4 970, 5 911, 6 200, and 8 575 Da （P 〈0.05, P 〈 0.01）. The aforesaid differentially expressed protein peaks occurred simultaneously in PDS and BSS. One week after interventional treatment, the expression of the serum protein peak was down-regulated in YDS syndrome with M/Z being 8 575 Da, showing statistical difference （P 〈0.01 ）. Conclusion Different peaks of serum proteins occurred in different Chinese medical syndrome types of PLC in the periopera- tive period of interventional treatment.