CAJ | 학술논문

目的探讨表面增强激光解吸离子化飞行时间质谱(SELDI-TOF-MS)技术在肾脏占位的良恶性鉴别诊断中的应用以及联合CT进行鉴别诊断的价值.方法 96例血清标本取自62例肾癌和34例肾脏良性占位患者,患者术前均接受过CT检查.应用SELDI-TOF-MS技术获得所有患者的金属亲和-铜离子(IMAC-Cu2+)蛋白芯片的表达图谱,随机采用42例肾癌和22例肾脏良性占位患者的血清蛋白质谱建立决策树诊断模型,并用其余患者进行双盲验证.结果利用质荷比分别为4657.56、2955.95和3278.00的3个蛋白峰建立了1个决策树诊断模型,其敏感性为85.7%(36/42),特异性为90.9%(20/22),双盲法验证后的敏感性为75.0%(15/20),特异性为83.3%(10/12).而联合CT的诊断结果,建模组和验证组的诊断特异性和阳性预测值均可达100%.结论利用质荷比分别为4657.56、2955.95和3278.00的3个蛋白峰所建立的诊断决策模型有助于鉴别肾脏占位的良恶性,联合临床CT诊断可明显提高诊断的效率.
목적 탐토표면증강격광해흡리자화비행시간질보(SELDI-TOF-MS)기술재신장점위적량악성감별진단중적응용이급연합CT진행감별진단적개치.방법 96례혈청표본취자62례신암화34례신장량성점위환자,환자술전균접수과CT검사.응용SELDI-TOF-MS기술획득소유환자적금속친화-동리자(IMAC-Cu2+)단백심편적표체도보,수궤채용42례신암화22례신장량성점위환자적혈청단백질보건립결책수진단모형,병용기여환자진행쌍맹험증.결과 이용질하비분별위4657.56、2955.95화3278.00적3개단백봉건립료1개결책수진단모형,기민감성위85.7%(36/42),특이성위90.9%(20/22),쌍맹법험증후적민감성위75.0%(15/20),특이성위83.3%(10/12).이연합CT적진단결과,건모조화험증조적진단특이성화양성예측치균가체100%.결론 이용질하비분별위4657.56、2955.95화3278.00적3개단백봉소건립적진단결책모형유조우감별신장점위적량악성,연합림상CT진단가명현제고진단적효솔.
Objective To identify the proteomic differences between renaX cell carcinoma(RCC)and renal benign masses and to evaluate the diagnostic value of parallel and serial test combining with CT and surface enhanced laser desorption/ionization-time of flight-mass spectrometry(SELDI-TOF-MS).Methods Serum samples were collected from 96 patients with tenal tumors.62 RCC cases and 34 renal benign mass cases,all of which had been evaluated by CT before surgery.The sera were analyzed using IMAC-Cu2+ProteinChip system by SELDI-TOF-MS.The decision tree was generated by Biomark Pattern based on the sera of 42 RCC cases and 22 renal benign mass cases and was blind-tested by the rest sera samples.The parallel method and serial method combining CT and SELDI were also used to distinguish RCC and renal benign masses.Results The sensitivity and specificity of the decision tree were 85.7%(36/42)and 90.9%(20/22)respectively.The sensitivity and specificity of the double-blind test were 75.0%( 15/20)and 83.3%(10/12)respectively.CT showed higher sensitivity but lower specificity in detecting RCC.While combining CT with SELDI-TOF-MS,the sensitivity and specificity could be improved.Conclusion Three peaks with the moleeular weights of 4657.56,2955.95,and 3278.00 were detected which are potentially useful for differentiating RCC and renal benign masses.Using serial method combining CT and the decision tree based on these three proteins improves the sensitivity and positive predictive values of diagnosing RCC to 100%.