高发区筛查人群食管鳞癌血清蛋白指纹图谱诊断模型的建立及临床价值

目的用表面增强激光解吸离子化飞行时间质谱(SELDI-TOF-MS)分析食管鳞癌患者血清蛋白表达谱的改变,筛选并建立高发区食管癌血清蛋白指纹图诊断模型,探究其临床价值。方法采用CM10蛋白芯片及SELDI-TOF-MS技术,对36例食管癌患者和38例正常对照者的血清进行蛋白指纹图谱检测,支持向量机分析实验数据,建立食管癌诊断模型,采用盲法验证。结果在分子量2000～20000范围内,共检测到31个蛋白质荷比峰,差异有统计学意义(P<0.01)。以4个质荷比峰建立了食管癌诊断模型,并用留一法交叉验证作为评估模型判别效果的方法,其准确率为85.1%,敏感性为86.1%,特异性为84.2%,真阳性率为83.8%。结论由4个质荷比峰构成的诊断模型可以区分食管癌和正常对照,为高发区食管癌的筛查与诊断提供了一条新的途径。

Establishment of a diagnostic model of serum protein fingerprint pattern for esophageal cancer screening in high incidence area and its clinical value

Objective To analyze the alterations of serum proteomic pattern in esophageal squamous cell carcinoma (ESCC)by SELDI-TOF-MS, to establish a diagnostic model of ESCC screening in high incidence area and investigate its clinical value. Methods SELDI-TOF-MS and CM10 proteinChip were used to detect the serum proteomic patterns of 36 cases of ESCC and 38 healthy control subjects in high incidence area. The data were analyzed and a diagnostic model was established by using support vector machine (SVM). The diagnostic model was evaluated by leave-one-out cross validation. Results At the molecular weight range of 2000 to 20 000, 31 protein peaks were significantly different between ESCC and controls (P<0.01). A diagnostic model consisting of 4 protein peaks could do the best in diagnosis of ESCC and controls. The accuracy was 85. 1%,sensitivity was 86.1% ,specificity was 84.2% ,and positive value was 83.8%. Conclusion The diagnostic model formed by 4 protein peaks, established in this study, can well distinguish ESCC from healthy subjects. It provides a new approach for ESCC screening in high incidence area.