低剂量螺旋 CT 扫描联合血清蛋白指纹图谱检测在肺癌早期诊断中的临床应用

Clinical application of low-dose CT coupled with serum protein fingerprinting in early diagnosis of lung cancer

目的：研究低剂量螺旋 CT （30 mA）扫描联合蛋白指纹图谱检测诊断早期肺癌的临床价值。方法应用表面增强激光解析电离化飞行时间质谱技术，分析50例肺癌患者和50例健康志愿者的血清，获得蛋白表达图谱，建立肺癌诊断模型。对30例肺部肿块患者进行低剂量 CT扫描联合血清蛋白质谱分析检测。结果应用表面增强激光解析电离化飞行时间质谱技术构建血清蛋白指纹图谱，在4763．26 m／z 、9725．37 m／z 、11534．16 m／z 和15335．22 m／z 蛋白峰构建一个肺癌诊断模型。盲筛分析显示诊断模型对肺癌诊断敏感性和特异性分别为75．0％和90．0％。低剂量 CT 筛查与低剂量 CT 联合蛋白指纹图谱分析对肺癌诊断的准确度分别为73．9％和85．7％。结论低剂量螺旋 CT 扫描联合血清蛋白质指纹图谱技术筛查早期肺癌具有较高的敏感度和准确度，对早期诊断肺癌有积极的临床意义。

Objective To survey the clinical value of low‐dose CT （30 mA ） coupled with serum protein fingerprinting （SPF） in the diagnosis of early lung cancer .Methods Protein expression profiles were ob‐tained via analyzing serums of 50 lung cancer patients and 50 healthy volunteers using surface enhanced la‐ser desorption/ionization time‐of‐flight mass spec‐trometry （SELDI‐TOF‐MS） and diagnostic model for lung cancer was established .Low‐dose CT cou‐pled with SPF analyses and detections were carried out in 30patients with pulmonary mass .Results SPFs were constructed using the SELDI‐TOF‐MS and diagnostic models for lung cancer at the pro‐tein peaks of 4763 .26 m/z ,9725 .37 m/z ,11534 .16 m/z and 15335 .22 m/z established .Blind screening a‐nalysis showed that sensitivity and specificity of diagnostic model to diagnosis of lung cancer were respec‐tively 75 .0% and 90 .0% .Accuracies of low dose CT screening and low dose CT coupled with SPF for di‐agnosis of lung cancer were respectively 73 .9% and 85 .7% .Conclusion Low‐dose CT coupled with SPF for the screening of early lung cancer have higher sensitivity ,accuracy ,and active clinical significance for early diagnosis of lung cancer .