CAJ | 학술논문

目的：分析乳腺癌与健康人血清蛋白质谱差异，筛选特异性蛋白标志物，建立乳腺癌诊断预测模型，评价其诊断价值。方法将58例乳腺癌和57例健康女性的血清，随机分为建模组和验证组，应用弱阳离子纳米磁珠（MB-WCX）结合基质辅助激光解吸离子飞行质谱（MALDI-TOF-MS）技术建立血清蛋白质谱，选择遗传算法建立乳腺癌诊断预测模型，利用诊断模型对验证组进行盲筛验证。结果通过蛋白质谱，筛选出29个显著差异蛋白质峰（P＜0．05）。其中乳腺癌中表达上调2个，表达下调27个，利用其中8个差异峰（质荷比分别为698．3、797.37、1449.56、1466．65、1520．74、1584．55、2379．26、2739．69）建立诊断模型，获得了96．55％（28/29）的敏感性和96.42％（27/28）的特异性，经独立样本双盲验证，得到灵敏度为93．10％（27/29），特异度为96．55％（28/29）。结论应用弱阳离子纳米磁珠联合MALDI-TOF-MS技术可筛选出血清蛋白质谱中的差异蛋白质，据此建立的诊断模型具有较高的敏感性和特异性，对于乳腺癌的辅助诊断有一定的临床意义。
목적：분석유선암여건강인혈청단백질보차이，사선특이성단백표지물，건립유선암진단예측모형，평개기진단개치。방법장58례유선암화57례건강녀성적혈청，수궤분위건모조화험증조，응용약양리자납미자주（MB-WCX）결합기질보조격광해흡리자비행질보（MALDI-TOF-MS）기술건립혈청단백질보，선택유전산법건립유선암진단예측모형，이용진단모형대험증조진행맹사험증。결과통과단백질보，사선출29개현저차이단백질봉（P＜0．05）。기중유선암중표체상조2개，표체하조27개，이용기중8개차이봉（질하비분별위698．3、797.37、1449.56、1466．65、1520．74、1584．55、2379．26、2739．69）건립진단모형，획득료96．55％（28/29）적민감성화96.42％（27/28）적특이성，경독립양본쌍맹험증，득도령민도위93．10％（27/29），특이도위96．55％（28/29）。결론응용약양리자납미자주연합MALDI-TOF-MS기술가사선출혈청단백질보중적차이단백질，거차건립적진단모형구유교고적민감성화특이성，대우유선암적보조진단유일정적림상의의。
Objective To analyze the differentially expressed proteins in the serum of breast cancer patients and control group so as to filter out protein markers of breast cancer ,and to build a predictive model of breast cancer. Methods Serum samples were collected from 58 patients with breast cancer and 56 healthy controls,and randomized into model construction group and validation group.WCX Magnetic bead and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS )technology were used to detect serum samples from patients with breast cancer and healthy individuals.Flex Analysis software was used to deal with mass spectrometry data.The model was built using ClinproTools2.2 software and was further evaluated in a blind test for reliability. Results Twenty-nine differentially expressed proteins in serum were screened by comparing serum protemic spectra between breast cancer patients and healthy individuals, including 2 up-regulated proteins and 27 down regulated ones.Eight proteins (M/Z 698.3,797.37,1 449.56, 1 466.65,1 520.74,1 584.55,2 379.26,2 739.69)were obtained for developing a ClinProt model which was able to classify breast cancer patients and healthy individuals with a sensitivity of 96.55%(28/29 )and a specificity of 96.42%(27/28 ).In a double blind validation,the ClinProt model yielded a sensitivity of 93.1 0%(27/29)and a specificity of 96.55%(28/29). Conclusion Combination of MALDI-TOF-MS and WCX magnetic bead technology can directly screen the differential expressed protein from healthy controls and breast cancer,and these proteins are suitable for diagnosis of early-stage breast cancer.They have clinical significance for enhancement of sensitivity and specificity of breast cancer diagnosis.