表面增强激光解吸电离飞行时间质谱技术筛查乳腺癌血清特异性蛋白质及其临床意义

目的 探讨表面增强激光解吸电离飞行时间质谱（SELDI-TOF-MS）技术筛查乳腺癌血清特异性蛋白质的临床意义。方法 应用SELDI-TOF-MS技术检测38例乳腺癌、33例乳腺良性疾病和43例健康对照者的血清蛋白质指纹图谱,并联合应用BioMarker Wizard 3．01及BioMarker Pattem Software5．01软件分析处理数据,筛选肿瘤标志物并建立诊断模型。结果 质荷比分别为M2077_07、M1827_38、M2650_51和M2060_62的4个蛋白质峰组合构建的诊断模型Ⅰ,鉴别乳腺癌和非乳腺癌的交叉验证敏感性为73．7％（28／38）,特异性为73．7％（56／76）。质荷比分别为M2251_62、M3405_56、M3428_16、M4666_98和M16239_8的5个蛋白质峰组合构建的诊断模型Ⅱ,鉴别Ⅰ期乳腺癌和乳腺良性疾病的交叉验证敏感性为84．8％（28／33）,特异性为55．6％（5／9）。质荷比分别为M1701_48、M3116_17、M1676_88、M5890_33和M2921_02的5个蛋白质峰组合的诊断模型Ⅲ,鉴别Ⅰ期与Ⅱ～Ⅳ期乳腺癌的交叉验证敏感性为88．9％（8／9）,特异性为86．2％（25／29）。结论 SELDI-TOF-MS技术在乳腺癌的筛查、早期诊断及临床分期判定等方面具有一定价值,值得进一步深入研究。

Detection and clinical significance of serum proteomic patterns of breast cancers by surface enhanced laser desorption/ionization time of flight mass spectrometry

OBJECTIVE: To detect the serum proteomic patterns in breast cancer patients by surface enhanced laser desorption/ionization time of flight (SELDI-TOF-MS) protein chip array techniques, to screen biomarker candidates and build diagnostic models in order to evaluate their clinical significance. METHODS: SELDI-TOF-MS technique and weak cation exchanger (WCX2) protein chip were used to detect the serum proteomic patterns of 38 patients with breast cancer, 33 patients with benign breast diseases and 43 normal control subjects. Biomarker Wizard 3.01 and Biomarker Pattern Software 5.01 were used in combination to analyze the data and to develop diagnostic models. RESULTS: Four protein peaks pattern (M2077_07, M1827_38, M2650_51 and M2060_62 mass/charge ratio [m/z]) was observed in the model I, and it could be used to distinguish breast cancer from non cancerous diseases. Its sensitivity and specificity were 73.7% (28/38) and 73.7% (56/76), respectively. The model II was formed by 5 protein peaks (M2251_62, M3405_56, M3428_16, M4666_98, M16239_8 m/z). When it was used in differential diagnosis between stage I breast cancer and benign breast diseases, the sensitivity and specificity were 84.8% (28/33) and 55.6% (5/9), respectively. Another 5 peaks (M1701_48, M3116_17, M1676_88, M5890_33, M2921_02 m/z) could build the model III to distinguish stage I and stage II approximately IV breast cancers. Its sensitivity and specificity were 88.9% (8/9) and 86.2% (25/29), respectively. CONCLUSION: Our findings suggested that application of SELDI-TOF-MS can be of great potential for early breast cancer screening, diagnosis and preoperative staging, and deserves further studies.