表面增强激光解析电离飞行时间质谱法筛选肺癌患者血清和肺泡灌洗液中标志蛋白的研究

Objective To detect the protein markers in serum and bronchoalveolar lavage fluid (BALF) of the patients with lung cancer by surface-enhanced laser desorption ionization time of flight mass spectrometry (SELDI-TOF-MS) technology, and to explore if they can be used as markers for the diagnosis of lung cancer.Methods SELDI-TOF-MS technology and protein chips weak cation exchange (WCX-2 chip) were used to detect the protein mass spectrum in serum and BALF of 35 patients with lung cancer and 18 cases of benign pulmonary diseases.The different protein markers were analyzed by Biomarker Pattern Software and the initial diagnosis models were set up.The diagnosis models were verified further by blind screen to confirm the efficacy of diagnosis.Results Five protein peaks in the sera of the patients with lung cancer were significantly higher (P ＜ 0.05 ).The protein peak with a mass/charge ratio (M/Z)of 5639 was selected to establish the classification tree model.The sensitivity of diagnosis was 80% (28/35) and the specificity was 78% (14/18).The results verified by blind screen showed a sensitivity of 85% (17/20),a specificity of 90% (9/10), a crude accuracy (CA) of 87% ( 26/30 ) and Youden' s index (γ) of 0.7.Eight protein peaks in the BALF of the patients with lung cancer were significantly higher ( P ＜ 0.05).The different protein peaks with M/Z of 7976 and 11 809 respectively were selected to establish the classification tree model.The sensitivity of diagnosis was 86% (30/35) and the specificity was 72% (13/18).The results verified by blind screen showed a sensitivity of 90% (18/20), a specificity of 90% (9/10), a CA of 90% (27/30) and γof 0.8.There was a complementary role in combination of differential proteins in serum and BALF and the sensitivity, specificity and accuracy of diagnosis for lung cancer were 100% by parallel test.Conclusions The SELDI-TOF-MS technology can screen out the differential protein markers in serum and BALF of the patients with lung cancer, which show high sensitivity and specificity as tumor markers.The differential proteins in the BALF may be more promising for clinical application.     

应用基质辅助激光解析电离飞行时间质谱法研究原发性胆汁性肝硬化的血清多肽谱

目的应用弱阳离子交换磁珠提取多肽结合基质辅助激光解析电离飞行时间质谱系统(MALDI-TOF-MS)分析原发性胆汁性肝硬化(PBC)患者的血清多肽谱,寻找具有潜在意义的血清标志物。方法收集105例血清样本,包括55例PBC患者、25例其他肝病患者和25例正常对照者血清样本,经弱阳离子交换磁珠纯化,MALDI-TOF-MS分析及ClinProTools生物信息学方法研究其血清多肽表达谱。结果在质荷比(m/z)1000～10 000 Da的范围内3组间共检测到158个血清多肽峰,其中83个有统计学意义(P<0.001),在PBC中表达上调的多肽有31个,表达下调的多肽有52个。组合m/z 1062.47、5356.13、4268.63、846.18、1945.31和6649.53Da 6个峰建立多肽诊断指纹图谱模型,该模型盲样验证的准确率在PBC组、正常对照组和其他肝病组分别为100%、81.8%和72.7%。结论可以利用MALDI-TOF-MS技术和ClinProTools软件来筛选PBC血清标志物,其在PBC诊断方面具有一定的价值。     

溃疡性结肠炎血清差异蛋白的筛选研究

目的 应用蛋白质组学寻找溃疡性结肠炎(UC)血清差异蛋白,初步探索UC可能的生物标志物.方法 收集UC患者30例和健康对照者30名的血清标本,双向凝胶电泳(2-DE)分离等量混合血清的蛋白质,运用图像分析软件进行比较和分析,识别差异表达蛋白质.应用基质辅助激光解吸/电离飞行时间质谱(MALDI-TOF-MS)鉴定部分差异蛋白质点.结果 UC组和对照组之间年龄、体重指数、吸烟情况和饮酒量的差异均无统计学意义(P值均＞0.05).初步筛选出UC患者与健康对照者存在明显差异的39个蛋白点,选择其中9个点,经质谱分析发现触珠蛋白、热休克转录因子2、受体酪氨酸激酶、醛脱氢酶、载脂蛋白C-Ⅲ、中心粒旁物质1在UC患者中表达水平升高,角蛋白1、细丝蛋白A结合蛋白1、肌球蛋白3在UC患者中表达水平降低.结论 采用蛋白质组学2-DE和质谱技术,筛选并鉴定出与UC相关的9个血清蛋白质,为提供新的UC生物学行为研究分子标志物奠定基础.     

基质辅助激光解吸电离飞行时间质谱在真菌快速鉴定中的应用

真菌是广泛分布于自然界的真核生物,对人类具有致病性的约300种。不同种真菌的生长特性、临床特点及耐药性不同。真菌生长缓慢,传统的培养鉴定方法所需时间较长,且日益多样化的真菌,使鉴定难度不断增加,这些均限制了临床的早期诊断和针对性治疗。基质辅助激光解吸电离飞行时间质谱(matrix-assisted laser desorption ionization-time of flight mass spectrometry,MALDI-TOF MS)是一种新兴的诊断技术,可以通过直接检测生物标志物(蛋白)来鉴定病毒、细菌、分枝杆菌等,具有操作简便、快速、准确率高、成本低的特点。本文对MALDI-TOF MS在真菌鉴定中的应用进行综述,发现其对酵母样真菌的正确鉴定率可达到94%以上,丝状真菌正确鉴定率也可达到89%,可满足临床实验室鉴定真菌的需求。     

基质辅助激光解析电离飞行时间质谱法与PCR产物测序法检测乙型肝炎病毒耐药变异的比较

目的 比较基质辅助激光解析电离飞行时间质谱法(MALDI-TOF MS)和PCR产物直接测序法检测HBV耐药基因位点的敏感性.方法共收集100例慢性乙型肝炎(CHB)患者血清,其中90例服用拉米夫定(LAM)等核苷(酸)类似物治疗1年以上、HBV DNA>500拷贝/ml,10例肝功能正常、HBV DNA>1×105拷贝/ml,未进行抗病毒治疗.对所有血清均采用MALDI-TOF MS法及PCR产物直接测序法(简称直接测序法)检测HBV P基因已知9个变异位点的变异情况,通过软件分析得出变异位点序列.根据样本量用相应的Pearson x2检验与Yates x2检验.结果 在服用LAM等核苷(酸)类似物的90份患者血清中,MALDI-TOF MS法测得53份阳性,检出率58.89%,共发现86个变异位点;PCR直接测序法仅检测到19份阳性,检出率21.11%,仅发现28个变异位点,两者间检出率差异有统计学意义(P<0.05).10例从未接受过口服抗病毒药物治疗的患者血清用两种检测方法均没有检测出变异位点.检测90例接受核苷(酸)类似物治疗的患者血清,HBV DNA水平在500～1000拷贝/ml、102～104拷贝/ml、104～105拷贝/ml时,质谱法阳性检出率分别为50.00%、52.08%和77.27%,而PCR直接测序法分别为0、8.33%和45.45%.在相同中、低滴度HBV DNA载量下,质谱法阳性检出率均高于测序法,两者差异有统计学意义(P<0.05).结论 MALDI-TOF MS法检测已知耐药位点的敏感性高于PCR直接测序法.

Abstract：

Objective To compare the sensitivities of MALDI-TOF MS and direct PCR sequencing on gene mutations demction of hepatitis B virus.Methods 100 serum samples from chronic hepatitis B patients were collected,which consisted of 90 serum samples(study group)from 90 chronic hepatitis B patients received nuclcoside analogues(NA)therapy for more than 1 year and HBV DNA titer still higher than 500 copies/ml and 10 serum samples (blank group)from 10 chronic hepatitis B patients never treated with antiviral therapy and HBV-DNA titer higher than 1×105 copies/m1.9 known mutations associated with HBV P gene in these samples were detected bv MALDI-TOF MS and direct PCR sequencing at the same time,TYPE4.0 software and Sequence Navigator software were used to analyze the results separately.Resuits(1)In study group,mutations were detected in 53 samples and the total mutation sites were 86 by MALDI-TOF MS with a positive detection rate of 58.89%,whereas only 19 samples were found with mutations and totally 28 mutation sites were detected by direct PCR sequencing,the positive detection rate was 21.11%. The positive detection rate by MALDI-TOF MS was higher than that by direct PCR sequencing and the difference was statistically significant (P < 0.05). In blank group,no mutations were detected by any method. (2) In study group,when the RBV DNA titers were at 500-1000 copies/ml,103-104 copies/ml and 104-105 copies/ml,the positive mutation detection rates by MALDI-TOF MS were 50%,52.08% and 77.27%respectively,higher than that by direct PCR sequencing,which were only 0%,8.33% and 45.45%. The difference was still statistically significant (P < 0.05). Conclusions MALDI-TOF MS had higher detection sensitivity for known mutation sites as compared to direct PCR sequencing method.     

基质辅助激光解吸电离飞行时间质谱技术在感染性疾病病原及耐药检测中的应用

基质辅助激光解吸电离飞行时间质谱技术作为蛋白质组学分析方法,具有高通量、高敏感度、操作简单、快速获得结果、可自建数据库等特点。该技术应用于感染性疾病病原鉴定及耐药检测,对临床感染患者的及时诊治意义重大。本文通过介绍该技术对菌种、无菌部位等各类标本的病原微生物进行快速鉴定及耐药检测的研究现状,探讨其面临的挑战和应用前景。     

肺结核患者强化治疗前后血清差异蛋白质质谱分析

目的研究肺结核患者强化治疗前后血清蛋白质谱的变化。方法利用弱阳离子(WCX)液体蛋白质芯片和基质辅助激光解吸电离飞行时间质谱(MALDI-TOF-MS)技术,对16例肺结核患者强化治疗前后的血清蛋白质谱进行比较分析。结果强化治疗前后有22种蛋白质的相对含量有明显差异,11种蛋白质在强化治疗后相对含量明显升高(P0.05),另外11种蛋白质在强化治疗后相对含量明显降低(P0.05)。结论肺结核患者强化治疗前后血清蛋白质谱存在明显差异。     

基质辅助激光解吸电离飞行时间质谱在结核病领域的应用进展

基质辅助激光解吸电离飞行时间质谱(MALDI-TOF MS)具有高通量、高速度、自动化等优点,成为生物大分子研究的重要工具。其在临床研究领域取得显著进展,在结核病研究领域的作用也日益凸显。作者主要介绍了MALDI-TOF MS在分枝杆菌菌种鉴定、结核病耐药性研究、结核病血清标志物的筛选、结核病易感基因多态性检测和抗结核药物代谢研究方面的应用进展,以加强对MALDI-TOF MS在结核病研究领域的认识。     

飞行时间质谱与TaqMan探针技术在结核病易感性相关基因单核苷酸多态性筛选中的应用

目的 对比分析飞行时间质谱技术（MALDI-TOF）和TaqMan探针筛选与结核病易感性相关单核苷酸多态性（SNP）位点的结果,以及联合应用的方法学和效果评价.方法 选取2010年10月至2011年4月在深圳市第三人民医院收治并确诊的结核病患者400例为结核病组,对照组为同时期收集的健康体检者300名,利用MALDI-TOF对选取的7个SNP位点（rs2227476、rs1800795、rs56077270、rs1800797、rs2227484、rs2227472和rs2227473）同时进行基因分型,初步筛选易感SNP位点;与结核病易感相关的单个SNP位点,采用基于TaqMan探针技术的实时荧光定量PCR对同样的标本再进行基因分型,比较两种方法的准确性与敏感度;以rs2227473位点为实例对分型结果的基因频率进行分析,确定肺结核的易感SNP.结果 MALDI-TOF分型成功率为99.7％（698/700）,TaqMan探针技术为98.4％（689/700）;在基因分型过程中,MALDI-TOF与TaqMan探针方法对1例标本的分型结果不一致,经过对此分型结果进行了测序验证,MALDI-TOF的分型结果正确,MALDI-TOF在准确性和敏感度比TaqMan法稍高.位点rs2227473基因频率分析中,结核病组G等位基因频率（90.3％,722/800）明显高于对照组（82.5％,495/600）（x2=6.911,P=0.009）.结论 上述肺结核易感基因的筛选方法是可行的;实例分析中,将两种方法联合应用,发现了IL-22基因rs2227473位点等位基因G可能与肺结核发病相关,两位点中等位基因A可能为保护性基因.     

SELDI技术筛选肺癌患者血清标志蛋白的临床价值

目的探讨表面增强激光解析电离飞行时间质谱（SELDI-TOF-MS）技术筛选肺癌患者血清标志蛋白的临床价值。方法用SELDI-TOF-MS技术、弱阳离子交换蛋白芯片,检测肺癌和肺良性病变患者的血清蛋白质质谱图;用Biomarker Pattern软件分析肺癌差异蛋白并初建其诊断模型,通过盲筛验证诊断模型。结果发现有统计学差异的蛋白峰20个,其中肺癌患者血清高表达蛋白质波峰14个,低表达蛋白质波峰6个;用质荷比2 090.77、2 503.31 Da的差异蛋白峰建立分类树模型,其诊断肺癌的灵敏度88%,特异度95%;盲筛验证灵敏度90%,特异度100%,粗符合率93.33%,Youden指数0.9。结论SELDI-TOF-MS技术筛选的肺癌血清差异性蛋白及分类树模型,诊断肺癌的灵敏度高、特异性好。     

高发区食管癌及癌前病变的血清蛋白质谱分析

目的 检测高发区食管癌及癌前病变患者血清蛋白质谱,建立蛋白指纹图谱模型并探究其筛查价值.方法 收集38名健康对照者、63例食管鳞状上皮不典型增生患者(I级26例,Ⅱ级26例,Ⅲ级11例)和36例进展期食管癌患者的内镜活检和血清标本,用CM10蛋白芯片及表面增强激光解析电离飞行时间质谱(SELDI-TOF-MS)技术检测标本的蛋白表达谱.支持向量机算法分别建立食管癌及癌前病变诊断模型,并经留一法交叉验证.结果 ①区分进展期食管癌和健康对照的诊断模型特异性为89.47%,敏感性为83.33%.②区分进展期食管癌和Ⅰ、Ⅱ、Ⅲ级不典型增生的诊断模型的特异性分别为92.31%、80.77%、90.91%,敏感性分别为80.56%、83.33%、94.44%.③在上述诊断模型中,质荷比(m/z)峰值在相对分子质量4291、5644、5664、8775处重复出现.结论 SELDI-TOF-MS技术和支持向量机算法的应用,为高发区高危人群中食管癌及癌前病变的早期筛查和诊断提供了一条新途径.4291、5644、5664、8775 4个质荷比峰对食管各级病变有相似的分类作用,可能是与食管癌变过程中相关的生物学标志物.     

基质辅助激光解析电离飞行时间质谱快速鉴定沙门菌临床分离株

目的评估基质辅助激光解析电离飞行时间质谱(MALDI-TOF MS)在沙门菌鉴定中的临床应用,并研究其影响因素。方法用传统血清学方法鉴定沙门菌的血清型,用MALDI-TOF MS对哥伦比亚血平板、HE平板、SS平板和麦康凯平板分别培养24h、72h、120h和168h的179株沙门菌进行鉴定。结果 179株沙门菌可分为38种血清型,肠炎沙门菌(21.2%)、斯坦利沙门菌(17.3%)和Ⅰ4,5,12:i:-沙门菌(16.2%)居前3位。所有菌株在血平板、HE平板、SS平板和麦康凯平板分别培养24h和72h均能被MALDI-TOF MS准确鉴定为沙门菌。MALDI-TOF MS的耗材成本约为微生物自动生化鉴定系统(Vitek 2)的1/3,检测时间约为Vitek 2的1/7。结论在血平板、HE平板、SS平板和麦康凯平板培养3d以内的沙门菌,MALDI-TOF MS均可以准确鉴定。与Vitek 2相比,MALDI-TOF MS检测的速度更快,消耗的成本更低,并且可以直接鉴定生长在选择性培养基的沙门菌。     

表面增强激光解析电离飞行时间质谱技术对周围型肺癌差异蛋白表达的研究

目的 筛选周围型肺癌患者血清、肺组织活检前后BALF中的差异蛋白,探讨其表达特点、影响因素及其临床意义.方法 选择2008年3月至2009年11月周围型肺癌及肺部良性病变患者各20例,应用表面增强激光解析电离飞行时间质谱(SELDI-TOF-MS)技术分别检测患者血清、活检前后BALF中的蛋白质质谱并初步建立分类树诊断模型.结果 (1)两组患者血清中检出6个差异蛋白峰,以质荷比为6637的差异蛋白建模诊断周围型肺癌的敏感度为70%(14/20),特异度为90%(18/20),正确率为80%(32/40),阳性预测值为88%(14/16),阴性预测值为75%(18/24),受试者工作曲线(ROC曲线)下而积(AUC)为0.73;(2)两组活检前BALF中检出11个差异蛋白峰,以质荷比为7982的差异蛋白建模诊断周围型肺癌的敏感度为85%(17/20),特异度为90%(18/20),正确率为88%(35/40),阳性预测值为89%(17/19),阴性预测值为86%(18/21),AUC为0.94;(3)两组活检后BALF中检出14个差异蛋白峰,以质荷比为7671的差异蛋白建模诊断周围型肺癌的敏感度为85%(17/20),特异度为100%(20/20),正确率为93%(37/40),阳性预测值为100%(17/17),阴性预测值为87%(20/23),AUC为0.93.结论 周围型肺癌活检前后BALF中检出的差异蛋白较血清中多,活检后BALF中的差异蛋白较活检前多.活检前质荷比为7982的差异蛋白与活检后质荷比为7671的差异蛋白在周围型肺癌患者BALF中的AUC值均＞0.9,高于血清;这2种差异蛋白可作为较好的早期诊断周围型肺癌的标志蛋白.

Abstract：

Objective To scan the protein mass spectra in the sera and bronchoalvolar lavage fluid (BALF) from patients with peripheral lung cancer, screen out the differential proteins, and explore the clinical significance of the differential proteins. Methods SELDI-TOF-MS was used to detect the protein mass spectra and to screen out the differential proteins in the sera and BALF collected before and after lung biopsy in 20 patients with peripheral lung cancer and 20 patients with benign pulmonary diseases. The differential proteins were analyzed and the initial diagnostic models were set up. Results ( 1 ) There were 6 differential protein peaks in the sera of the 2 groups ( P ＜0. 05 ＝. The protein with a mass/charge ratio ( M/Z) of 6637 was selected to establish the diagnostic model. The sensitivity of diagnosing peripheral lung cancer was 70% (14/20) ,the specificity 90% ( 18/20), the accuracy 80% (32/40), the positive predictive value ( PV + ) 88% ( 14/16), the negative predictive value( PV - ) 75% ( 18/24), and the area under the ROC curve (AUC)was 0.73. (2) There were 11 differential protein peaks in the BALF collected before lung cancer biopsy of the 2 groups ( P ＜ 0. 05 ＝. The protein with a M/Z of 7982 was selected to establish the diagnostic model. The sensitivity of diagnosing peripheral lung cancer was 85% ( 17/20 ), the specificity 90% ( 18/20), the accuracy 88% (35/40), the PV + 89% ( 17/19), the PV - 86% ( 18/21 ), and the AUC was 0. 94. (3) There were 14 differential protein peaks in the BALF collected after lung cancer biopsy of the 2 groups ( P ＜0. 05 ＝. The protein with a M/Z of 7671 was selected to establish the diagnostic model.The sensitivity of diagnosing peripheral lung cancer was 85% (17/20) ,the specificity 100% (20/20), the accuracy 93% (37/40), the PV + 100% (17/17), the PV- 87% (20/23), and the AUC was 0. 93. Conclusions There were more differential proteins in BALF as compared with sera. There were more differential proteins in the BALF collected after lung biopsy as compared to that before lung biopsy. The AUC of the diagnostic models set up by proteins in BALF collected before and after lung biopsy were all above 0. 9 and showed higher efficiency for the diagnosis of peripheral lung cancer as compared to proteins in sera.These differential proteins may be better tumor markers for the diagnosis of peripheral lung cancer at the early stage.     

应用SELDI-TOF-MS技术建立肝癌筛选血清蛋白质指纹图谱模型

目的:建立肝癌筛选血清蛋白质指纹图谱模型．方法:用表面加强激光解析电离飞行时间质谱技术(SELDI-TOF-MS)及WCX2蛋白芯片获得新发肝癌、肝硬化患者和正常人血清的蛋白质指纹图谱,用计算机软件进行比较分析,建立肝癌的筛选模型．结果:肝癌患者与健康对照组血清蛋白质指纹图谱之间有5个标志蛋白(4477,8943,5181, 8617,13 761 Da)在肝癌患者血清中高表达,肝癌患者与肝硬化患者血清蛋白质指纹图谱之间2个标志蛋白(4477,13 761 Da)在肝癌患者血清中高表达,1个标志蛋白(4097 Da)在肝癌患者血清中低表达．SELDI-TOF-MS技术的特异性(60／60,100％);敏感度(18／20,90％)．分析系统筛选出4477,8943,13 761,4097 Da标志蛋白建立的肝癌诊断模型．结论:建立的血清蛋白质指纹图谱模型能够区分肝癌与非肝癌患者,SELDI-TOF-MS在肝癌的诊断及肿瘤特异性蛋白质生物标志分子的筛选等方面具有一定价值．     

血清多标志物蛋白质谱在原发性肝细胞癌诊断中的应用

HCC早期诊断和早期治疗是提高患者生存率的关键。表面增强激光解吸电离飞行时间质谱（SELDI-TOF-MS）技术是一项近年来新兴的临床蛋白组学实用技术,已被广泛地用于肿瘤标记物的筛查等研究。本研究比较了HCC患者和健康对照者血清蛋白质质谱,通过决策树分类技术筛选出一组特异的标志蛋白,建立HCC诊断模型,为HCC的早期预警和早期诊断提供更敏感可靠的指标。[第一段]