表面增强激光解析离子化飞行时间质谱技术筛查早期肺腺癌的临床价值

Clinical value of surface enhanced laser desorption/ionization time of flight mass spectrometry in screening early lung adenocarcinoma

目的探讨表面增强激光解析离子化飞行时间质谱技术(SELDI-TOF-MS)筛查结节状磨玻璃影的早期肺腺癌的临床应用价值。方法所有患者进行CT检查显示:病灶直径≤2cm,结节状磨玻璃影,且实性成分大于30%。对CT检查上述异常的患者,术前采用SELDI-TOF-MS进行血清蛋白指纹图谱检测,显示某一肺癌相关的蛋白峰增高,即考虑为早期肺腺癌。分别将SELDI-TOF-MS、CT检查检查结果与术后病理诊断结果进行对比,计算诊断的正确率、灵敏度和特异度。结果 CT检测的诊断正确率为72.29%(60/83),灵敏度为72.97%(54/74),特异度为66.7%(6/9);SELDITOF-MS检测的诊断正确率为97.50%(78/80),灵敏度为97.3%(72/74),特异度为100%(6/6)。两者比较差异均具有统计学意义(P<0.01)。结论血清蛋白指纹图谱技术筛查结节状磨玻璃影的早期肺腺癌具有较高的灵敏度和特异度,可提高早期肺癌的正确率。

Objective To investigate the clinical value of surface enhanced laser desorption/ionization time of flight mass spectrometry（SELDI-TOF-MS）for the screening of early lung adenocarcinoma with ground-glass opacity.Methods All patients underwent CT examination.The diameter of lesions was less than 2 cm,nodular ground glass opacity,and the solid component was more than 30%.The serum protein fingerprints were detected by SELDI-TOF-MS before the CT examination of the abnormality.It showed that the protein peak associated with a certain lung cancer was increased,therefore,the early lung adenocarcinoma was considered.The diagnostic accuracy,sensitivity and specificity of SELDI-TOF-MS and CT examination were compared with those of postoperative pathological diagnosis.Results The diagnostic accuracy of CT was 72.29%（60/83）,the sensitivity was 72.97%（54/74）,the specificity was 66.7%（6/9）;the diagnostic accuracy of SELDI-TOF-MS was97.50%（78/80）,the sensitivity was 97.3%（72/74）,and the specificity was 100%（6/6）.The differences between CT and SELDI-TOF-MS were statistically significant（P〈0.01）.Conclusion The serum protein fingerprinting technique has high sensitivity and specificity in screening early lung adenocarcinoma with nodular glass shadow,and it can improve the accuracy of early lung cancer.