恶性胸腔积液蛋白质组学研究进展

恶性胸腔积液是肿瘤患者常见的临床问题,研究恶性胸腔积液中的蛋白质是否可以用来作为肺癌及其他相关疾病的诊断标志物很有意义.蛋白质组学的出现拓宽了人们的视野并加快了医学研究进展,如今蛋白质组学的研究方法在生物标志物的鉴定乃至肿瘤发生机制的探索中担当重要角色,蛋白质组学技术的迅猛发展为全面有效地分析恶性胸腔积液的蛋白质组分提供了技术支持,本文对近年蛋白质组学技术发展及恶性胸腔积液蛋白质组学研究进展进行综述.     

基于蛋白质组学技术的肝癌实验诊断研究进展

多年来, 寻找新的肝癌标志物的研究一直进展缓慢. 以双向电泳、新型质谱分析为主的蛋白质组学方法为寻找肝癌标志物提供了良好的技术平台, 促进了肝癌实验诊断研究的快速发展. 本文综述了近年来基于蛋白质组学技术的肝癌实验诊断临床研究的主要进展.     

呼出气体冷凝物的蛋白质组学研究用于肺癌早期诊断的探讨

蛋白质组学研究的新方法、新技术的出现使其在肿瘤的研究中展现出广阔的应用前景。呼出气体冷凝物是一种尚处于研究阶段的无创、简易的新型检测肺癌的方法,包含了一系列来源于下呼吸道的生物标志物,如蛋白质。从这一视角分析以呼出气体冷凝物为样本、蛋白质组学技术为研究手段,来检测肺癌肿瘤标志物的潜力及面临的局限,论述其用于肺癌早期诊断...     

支气管哮喘蛋白质组学研究的现状和前景

蛋白质组学是后基因组时代一项重要的生命科学的研究手段,近年在支气管哮喘的发生、发展方面的研究方兴未艾.它主要依托质谱和二维电泳技术比较正常和病理状态下组织或细胞的差异蛋白质的表达,结合生物信息学的方法,从而研究疾病的发病机制及为临床提供诊断和治疗靶点.在哮喘的研究中目前主要是比较蛋白质组学的研究,发现新的靶标为临床服务同时探讨其发病机制.     

胰腺癌的蛋白质组学研究进展

胰腺癌高居于癌症致死病的第四位,诊断后5年生存率小于5%,需要寻找新型生物标志物来提高早期诊断,并发现有效的治疗新靶点。蛋白质组学技术的发展提供了更好的分辨率和灵敏度,有助于在蛋白水平上更好地理解肿瘤发病机制,进而提高早期诊断和治疗的能力。近来在胰腺组织、胰液、血清、血浆、细胞株的蛋白质组学诸多研究鉴定了胰腺癌的差异表达蛋白,并发现新的潜在诊断生物标志物。本文就近年来胰腺癌的蛋白质组学研究结果及局限性做一综述。     

CT技术在早期肺癌诊断中的应用

肺癌为恶性肿瘤主要死亡原因之一,其发病率呈逐渐增高趋势.全世界每年有大约三百万新增肺癌患者,25％的女性癌症死亡是因为肺癌,而男性的该比例达到了32％;我国随着工业化进程的不断提高,肺癌的发病率和死亡率有不断上升的趋势,严重危害人类的健康.目前CT技术是早期发现和诊断肺癌的最普及和最基本的方法之一,其发展为肺癌的诊断提供了方便实用的新手段,也为了解癌症的发展提供了医学影像学证据.本文就CT技术在早期肺癌的诊断中的相关应用综述如下.     

蛋白质芯片激光解析电离技术在肺癌研究中的应用

蛋白质芯片表面加强激光解析电离-飞行时间-质谱(SELDI-TOF-MS)技术是蛋白质组学研究的全新技术平台,进一步提高了蛋白质分离和鉴定的速度。并且在肺肿瘤生物标志物筛选、鉴别肺癌抗原和蛋白质指纹图谱方面取得突破性进展。今后该技术在肿瘤蛋白质组学研究中有更加广阔的应用前景。     

人工神经网络模型在肺癌诊断中的应用

目的 探讨人工神经网络(ANN)技术对肺癌的诊断价值.方法采用电化学发光免疫法分别测定胸腔积液及血清中肿瘤标志物癌胚抗原(CEA)、糖类抗原125(CA-125)、糖类抗原19-9(CA-19-9)和肿瘤特异性生长因子(TSGF)的水平,建立肿瘤标志物ANN模型,并验证该ANN模型对肺癌与肺良性疾病的鉴别诊断价值.结果 4种肿瘤标志物联合检测的灵敏度为97.4%,特异度为56.1%,准确率为84.9%;ANN模型对肺癌鉴别诊断的灵敏度为100%,特异度为93.3%准确率为97.8%.结论 ANN模型能够对肺癌和肺良性疾病进行鉴别诊断,可为肺癌提供临床辅助诊断.     

代谢组学在肺癌中的应用

代谢组学是20世纪末逐渐发展起来的一门组学技术.它作为系统生物学的一部分,正广泛应用于包括肿瘤在内的各种疾病的诊断、治疗、预后等方面.肺癌是发病率和病死率最高的肿瘤,肺癌的早期和晚期发现在患者5年生存率上差异巨大,故肺癌的早期诊断意义重大.代谢组学除了应用于确定肺癌诊断的标志物,也可应用于确定肺癌的预后及治疗措施毒性或有效性的相关标志物.后者使得肺癌患者的治疗更加个体化成为可能.同时代谢组学研究也使得我们对肺癌的病理生理过程理解得更加深入.本文就代谢组学的定义和研究方法、代谢组学两大主要技术平台核磁共振和质谱的特点及其在肺癌中的应用作一综述.     

肺癌诊断的某些新的进展

本文综述了影像学，组织活检，镜检，肿瘤标记物及基因诊断等在肺癌诊断中的某些进展，这些新技术的应用为肺癌的早期诊断，分期，鉴别诊断等方面提供新的帮助。     

肺癌早期诊断的临床进展

肺癌是发病率及病死率增长最为迅速的恶性肿瘤,已成为威胁人类健康和癌症死亡主要病因之一。肺癌5年生存率13％～15％,早期诊断率仅15％。提高肺癌的早期诊断是改善肺癌5年生存率的关键。整合影像学方法和微创检查技术,同时开展痰细胞学检查、血清肿瘤标记物测定对提高肺癌的早期诊断具有临床意义。本文回顾影像学诊断方法、痰细胞学检查、微创介入诊断技术临床应用,以及近年来国外开展的肺癌诊断技术的临床进展。     

Molecular biology of lung cancer

Lung cancer is a major cause of mortality worldwide and the overall survival rate has not improved significantly in the past 20 years. Of the more than 150,000 new cases of lung cancer diagnosed in Europe every year, less than 10% of patients can be cured and enjoy long-term survival. The role of tobacco smoking as a cause of lung cancer has been conclusively established. Early diagnosis of lung cancer, based on conventional screening procedures using sputum cytology and chest radiography, has been so far unable to decrease lung cancer mortality. We discuss here the possibility that novel, more specific molecular markers, beside providing new understanding of the process of lung carcinogenesis, may also constitute new tools for early diagnosis allowing for screening of high-risk individuals, determination of prognosis, and identification of innovative treatments.     

Clinical features of 5,628 primary lung cancer patients: experience at Mayo Clinic from 1997 to 2003

STUDY OBJECTIVES: To improve the current understanding of the etiology and natural history of primary lung cancer, we need to study the dynamic changes of clinical presentation and prognosis among a large number of patients with newly diagnosed lung cancer. In this report, we present the clinical features and survival rates up to 5 years of a patient cohort. DESIGN: We identified 5,628 primary lung cancer patients between 1997 and 2002 and followed them through 2003 using multiple, complementary resources. MEASUREMENTS AND RESULTS: Of the 5,628 patients, 58% were men with a mean age at lung cancer diagnosis of 66 years, and 42% were women with a mean age at diagnosis of 64 years. Ten percent were < 50 years, and 8% were > 80 years at diagnosis. A tobacco smoking history was present in 89% of patients, and 40% were smoking at the time of diagnosis. The estimated overall 5-year survival rates of patients with non-small cell lung cancer (NSCLC) by disease stage was as follows: IA, 66%; IB, 53%; IIA, 42%; IIB, 36%; IIIA, 10%; IIIB, 12%; and IV, 4%. The 5-year survival rate of patients with small cell lung cancer was 22% for limited disease and 1% for extensive disease. Approximately 50% of all patients are participants in one or more research studies, and nearly 75% of these patients have donated biological specimens for research. CONCLUSION: The survival rate of this cohort of lung cancer patients was slightly improved compared with earlier reports, particularly for patients with low-stage NSCLC. Our patient and biospecimen resource has enabled us to obtain timely results from clinical and translational research of lung cancer.     

Molecular Profiling of Non-Small Cell Lung Cancer: Of What Value in Clinical Practice?

Future improvements in lung cancer survival are likely to come from delineating its putative oncogenic pathways. The development of microarray technology to perform thousands of simultaneous genetic experiments and the linking of this to clinical information is an imperative for refining our current treatments and developing new ones. This paper reviews the state of this research, describes a typical microarray experiment and the implications for diagnosis and treatment of non-small cell lung cancer.     

血清肿瘤标志物在肺癌早期诊断中的应用现状及研究进展

肺癌是目前最常见的恶性肿瘤之一,其5年生存率不足14％。提高肺癌患者生存率的关键在于早期诊断。血清肿瘤标志物作为有效的诊断方法倍受临床关注。本文综述了目前肺癌血清标志物研究现状和进展。     

青年人肺癌临床特点及手术疗效分析

目的探讨青年人（≤40岁）肺癌的临床特点和手术治疗效果，以提高早期诊断水平，提高远期疗效。方法对1998～2004年我院经病理确诊的542例原发性肺癌进行回顾性总结，对其中70例青年人肺癌临床症状、X线表现、吸烟情况、病理类型、肿瘤分期及手术疗效等方面进行分析，并与同期收治的472例（41～74岁）对照组的肺癌患者进行对比。结果青年人肺癌早期症状轻、误诊率高，应注意肺外体征，对烟龄早，两上肺内病灶伴胸痛要尤其重视。本文统计青年人肺癌腺癌居首位（占51．4％），其次为小细胞癌（25．7％）和鳞癌（22．8％）。手术切除率低（44．3％），远期效果差。总体5年生存率（19．4％）低于对照组（48．6％）。其中1年生存率（96．8％）高于对照组（94．6％），3年生存率（45．1％）低于对照组（65．2％）。青年组全肺切除及局部切除5年生存率为零，而对照组分别为17．6％和7．1％。肺叶切除术后生存率好于全肺和局部肺切除。结论掌握青年人肺癌的临床特点是早期诊断的关键，放宽手术指征，提高切除率以获得较好的远期疗效。     

不同肺活检方法诊断肺癌的价值比较

目的对比分析3种肺活检不同方法在疑似肺癌中诊断中的价值和利弊。方法门诊及住院患者经肺部X线照片和CT检查结果诊断为肺部块影而疑似肺癌的患者78例,分别应用经支气管镜肺活检(TBLB)、CT下经皮肺活检、外科肺活检进行检查,对病理的及临床资料进行对比分析。结果报道78例疑似肺癌患者,诊断率为46.15%。TBLB术确诊率为39.5%,外科肺活检术确诊率为91.7%。CT下经皮肺活检术确诊率为35.7%。而Ⅰ～ⅢA检出率为34.6%。并发症发生率依次为外科肺活检、CT引导下肺活检、TBLB。结论 TBLB是诊断肺癌的首选确诊手段,其优点为阳性率高、费用低、并发症小,有利于肺癌的鉴别诊断和分期,而位于周边型肺癌应首选CT下经皮肺活检,对于其他未能确诊且疑难肺部肿块者宜选用外科肺活检。     

Early detection of lung cancer

The overall 5-year survival of lung cancer is only 10% in Europe and 15% in the United States, and progress in curative treatments during the last 20 years has been modest. Late diagnosis of extensive disease is the main reason of failure. Early detection with low-dose spiral computed tomography (CT) is one of the most promising development of clinical research, and continuous improvements in technology can make this instrument more effective than mammography in breast cancer detection. In order to prove the benefit of early detection by reduction of lung cancer mortality, we need to enroll large numbers of high-risk individuals in multicentric prospective randomized trials combining primary prevention by smoking cessation with diagnostic intervention with low-dose spiral CT, optimal management of cancer and minimum damage for healthy individuals. Molecular biology research within early detection trials, combining genomic and proteomic analysis of blood and sputum, may improve the differential diagnosis, define the individual risk of cancer incidence and failure, and help target therapies on the basis of biologic profile.     

蛋白质指纹图谱技术在肺结核、肺癌鉴别诊断中的应用研究

目的 探索应用表面增强激光解析离子化飞行时间质谱（SELDI-TOF-MS）技术于肺结核、肺癌的鉴别诊断。 方法 肺结核、肺癌患者及正常人各65例,收集其血清标本,采用WCX2芯片技术对血清蛋白进行捕获,用蛋白芯片阅读器PBSⅡ对芯片进行扫描、分析。 结果65例活动性肺结核与65例肺癌患者血清蛋白质谱数据的比较,4个蛋白峰(5 335 m/z、8 048 m/z、11 700 m/z、11 683 m/z)倾向于肺结核,以此鉴别肺癌差异有统计学意义(P<0.01)。该诊断模型判别的总准确率为74.6%（97/130）,灵敏度80.0%(52/65),特异度69.2%(45/65)。 结论 此方法简便、快速,标本用量少,为肺结核、肺癌患者提供了1种新的无创诊断和鉴别诊断方法 。     

The future in diagnosis and staging of lung cancer. Molecular techniques

Lung cancers at the same stage of disease have markedly different rates of disease progression. In this review, we will address current molecular techniques which provide new opportunities according to diagnosis, prediction of survival or selection of therapy. New molecular techniques might be helpful in TNM staging and lead to additional individual prognostic information. A revised TNM system could include a TNM component and a molecular supplemental component allowing new markers to be evaluated without undermining the value of classic TNM staging. Furthermore, molecular techniques might be helpful in the early or differential diagnosis of lung cancer. Since many new targeted agents are effective only if their respective molecular markers are mutated or expressed at sufficient levels, DNA-based or RNA-based techniques have the potential to influence treatment selection in the future. Overall, we can expect that molecular markers will contribute to a more personalized lung cancer treatment.