结直肠癌患者血清蛋白质谱检测的意义

目的 比较原发性结直肠癌与结直肠癌转移患者血清蛋白质谱,筛选与结直肠癌转移相关的蛋白标志物.方法 采用表面增强激光解析电离-飞行时间质谱技术测定219例结直肠癌患者和健康人血清标本.将标本随机分为训练组(无转移患者57例,转移患者63例,健康人42例)和盲法测试组(无转移患者26例,转移患者31例).分析比较训练组结直肠癌转移与无转移患者及健康人血清蛋白质谱差异,筛选与转移相关的蛋白标志物,并用单盲法验证筛选出差异标志物的灵敏度与特异性.结果 在平均分子质量为2000～30000范围内比较原发性结直肠癌患者与健康人血清蛋白质谱,发现31个蛋白质峰差异有统计学意义,按P值由小到大前5位的蛋白质峰分别为3240.7、9289.3、5334.4、4596.1和4792.4;比较结直肠癌转移患者与健康人血清,发现38个蛋白质峰差异有统计学意义,按P值由小到大前5位的蛋白质峰分别为3240.7、9289.3、9184.4、3191.5和9340.9;单独比较原发性结直肠癌与结直肠癌转移患者血清,筛选出两个蛋白质峰(9184.4和9340.9)差异有统计学意义,联合应用这两种蛋白可以将转移与无转移结直肠癌患者正确分组,正确分组率分别为93.6%和91.2%.经测试组盲法验证得出的灵敏度和特异性分别为90.3%和88.5%.结论 用表面增强激光解析电离-飞行时间质谱技术可以监测结直肠癌转移,血清蛋白质谱中的差异蛋白可能是转移相关蛋白.

A study on the serum proteomics in patients of colorectal cancer

Objective To detect biomarker proteins in relation to metastasis by comparing serum protein profiles of primary colorectal cancer patients with or without metastasis. Methods A total of 219 serum samples were analyzed using surface enhanced laser desorption ionization time of flight mass spectrometry(SELDI-TOF-MS).The samples were divided into two groups:the training group consisting of 57 primary colorectal cancer patients、63 metastatic colorectal cancer patients and 42 healthy controls,and the test group consisting of 26 primary colorectal cancer patients and 31 metastatic colorectal cancer patients.Samples in training group were analyzed to identify serum biomarker proteins which could differentiate colorectal cancer patients with or without metastasis.The sensitivity and specificity of biomarker proteins were examined by results from blind test group. Results In the m/z region of 2000～30000,31 proteins had statistically significant difference between primary colorectal cancer patients and healthy controls.The m/z of difierentiated proteins were respectively 3240.7、9289.3、5334.4、4596.1 and 4792.4 according to P value.38 proteins had statistically significant diffefence between metastatic colorectal cancer patients and healthy controls.The m/z of differentiated proteins were respectively 3240.7、9289.3、9184.4、3191.5 and 9340.9 according to P value.Only two protein peaks(9184.4 and 9340.9)were found of statistical difference between primary eolorectal cancer patients and metastatic colorectal cancer patients.The sensitivity and specificity of the combination use of the two biomarkers were respectively 90.3% and 88.5% in the test group. Conclusion SELDI-TOF-MS was helpful to find protein biomarkers with relation to metastasis in colorectal carcinoma patients.