CAJ | 학술논문

目的：通过纳米磁珠联合质谱技术筛选并鉴定大肠癌患者特异性蛋白标志物及在大肠癌早期诊断中的意义。方法采用弱阳离子纳米磁珠联合MALDI-TOF-MS质谱技术分析102例大肠癌患者和124例健康对照者血清蛋白表达谱，并建立蛋白分类模型，采用LCQ液质联用质谱（LC-MS）技术鉴定已筛选出的特异性蛋白，并用该模型在双盲模式下从使用未建立模型的其它样本中选取59例大肠癌血清标本（Dukes A、B、C期各33例、18例和8例）和正常体检者90例进行检测以验证其诊断的准确性。结果大肠癌组与健康对照组间有8个蛋白表达存在明显差异（P<0.05），其中大肠癌患者中有3个蛋白质高表达。差异蛋白质峰[质荷比（m/z）2963.17、4095.13、5906.83和38146.5]为最佳的大肠癌患者血清学诊断模型，敏感性为82.3%，特异性为90.3%，阳性预测值为90.3%，ROC曲线下面积为0.922。在双盲模式下的诊断准确率为89.83%，排除率为94.44%。其差异蛋白峰和大肠癌的分期无明显相关。LC-MS成功鉴定到m/z 2963.17（myosin-7B）、m/z 5906.83（Myoferlin）。结论纳米磁珠联合质谱技术对大肠癌患者血清学诊断具有较高灵敏度和特异性，并通过LCQ液质联用质谱成功鉴定到的myosin-7B和Myoferlin可能有助于大肠癌的早期诊断。
목적：통과납미자주연합질보기술사선병감정대장암환자특이성단백표지물급재대장암조기진단중적의의。방법채용약양리자납미자주연합MALDI-TOF-MS질보기술분석102례대장암환자화124례건강대조자혈청단백표체보，병건립단백분류모형，채용LCQ액질련용질보（LC-MS）기술감정이사선출적특이성단백，병용해모형재쌍맹모식하종사용미건립모형적기타양본중선취59례대장암혈청표본（Dukes A、B、C기각33례、18례화8례）화정상체검자90례진행검측이험증기진단적준학성。결과대장암조여건강대조조간유8개단백표체존재명현차이（P<0.05），기중대장암환자중유3개단백질고표체。차이단백질봉[질하비（m/z）2963.17、4095.13、5906.83화38146.5]위최가적대장암환자혈청학진단모형，민감성위82.3%，특이성위90.3%，양성예측치위90.3%，ROC곡선하면적위0.922。재쌍맹모식하적진단준학솔위89.83%，배제솔위94.44%。기차이단백봉화대장암적분기무명현상관。LC-MS성공감정도m/z 2963.17（myosin-7B）、m/z 5906.83（Myoferlin）。결론납미자주연합질보기술대대장암환자혈청학진단구유교고령민도화특이성，병통과LCQ액질련용질보성공감정도적myosin-7B화Myoferlin가능유조우대장암적조기진단。
Objective To screen and identify early specific protein markers of colorectal cancer (CRC)by MALDI-TOF-MS technology. Methods Weak cationic nano magnetic beads combined with MALDI-TOF-MS were used to profile differentially expressed proteins between 102 cases of CRC patients and 124 healthy controls in the serum protein,then constructing protein classification as diagnosis model and identifying specific proteins by LCQ liquid chromatography-mass spectrometry. Selected serum specimens of 59 patients with CRC and 90 normal healthy persons from samples in unestablished model were used to verify the accuracy of diagnosis. Results We found that eight difference protein peaks between CRC patients and healthy group(P<0.05) and three proteins showed high expression in the CRC patients. A diagnostic model with four proteomic features (m/z 2963.17,4095.13,5906.83 and 38146.5) of CRC patients was generated using Biomarker Patterns Software 5.0 with best performance, the sensitivity was 82.3%,specificity was 90.3%,the positive predictive value was 90.3%,and area under the ROC curve was 0.922. The accuracy rate of diagnosis in double blind mode was89.83%,removal rate was 94.44%. The difference between the protein peaks and the staging of CRC hadno correlation. The identification results showed that m/z 2963.17 (MYH7B,myosin-7B) and m/z 5906.83 (MYOF Isoform 1 of Myoferlin) by LCQ mass spectrometry coupled with liquid. Conclusion Myosin-7B and Myoferlin screened by nano magnetic beads combined with MALDI-TOF-MS technology may contribute to early diagnosis of CRC.