肾母细胞瘤血清蛋白质标记物检测与分期模型构建研究  

The stage for the nephrohlastoma： Specific serum protein hiomarkers or CT scan

作　　者：王家祥[1] 陈新让[1] 张蛟[1] 刘秋亮[1] 李苏宁[1] 余捷凯[2] 郑树[2] 

机构地区：[1]郑州大学第一附属医院小儿外科,郑州450052 [2]浙江大学第二附属医院肿瘤研究所

出　　处：《中华小儿外科杂志》2007年第2期90-94,共5页Chinese Journal of Pediatric Surgery

基　　金：国家自然科学基金资助项目（30571930）

摘　　要：目的筛选出肾母细胞瘤患儿特异性血清蛋白质标记物，建立肾母细胞瘤临床分期模型与CT分期进行对照分析，并评价其临床应用价值。方法应用SELDI-TOF-MS技术检测80例血清标本（术前肾母细胞瘤30例，其他恶性肿瘤30例，正常儿童20例），用ZUCI-Protein Chip Data Analyze System分析软件进行数据处理，结合支持向量机（support vector machine，SVM）建立肾母细胞瘤临床分期模型。结果筛选出2个m／z位于4153．9和3257．6的蛋白质标记物，区分肾母细胞瘤Ⅲ和Ⅳ期与肾母细胞瘤Ⅰ和Ⅱ期蛋白质谱差异表达模型的敏感性为100％，特异性为93。8％；区分肾母细胞瘤与正常儿童、腹腔实体肿瘤及肾脏其他恶性肿瘤的特异性是100％，敏感性是100％、80．0％、100％；临床分期模型可以特异性地将各期区分开来，其特异性及敏感性均为100％；通过肾母细胞瘤早期诊断模型中的2个m／z（6984．4，6455．5）血清标记物进行分析得出肾母细胞瘤各期情况如下：Ⅳ期相对于Ⅲ期低表达；Ⅲ期相对于Ⅱ期低表达；Ⅱ期相对于Ⅰ期低表达；Ⅰ期相对于正常儿童低表达；后者相对高表达；临床分期越晚，m／z强度就越低表达。蛋白芯片分期准确性与病理一致，达到100％，在分期定性问题上优于CT（Ⅰ期100％，Ⅱ期85．0％，Ⅲ期85．0％，Ⅳ期75．0％）。结论用SELDI-TOF-MS结合SVM建立的肾母细胞瘤临床分期模型可弥补CT在肾母细胞瘤分期定性问题匕的不足。Objective To investigate the different values of specific serum protein biomarkers and CT scan in the tumor stage in nephroblastoma. Methods Eighty serum samples （including 30 preoperative nephroblastomas, 30 other malignant tumors, 20 healthy children） were detected by SELDI-TOF-MS. The protein fingerprint data were analyzed by ZUCI-Protein Chip Data Analyze System. SVM was used to establish the nephroblastoma clinical staging pattern. The tumor stage according to the manifestation of CT scan in these tumors was also recorded. Results Two protein biomarkers were found （m/z ratio： 4153. 9, 3257. 6）. These two markers separated nephroblastoma Ⅲ ＋ Ⅳ from Ⅰ ＋ Ⅱ with sensitivity of 100% and specificity of 93. 8%, and separated nephroblastoma from healthy children, abdominal solid tumor and renal malignant tumor with specificity of 100% and sensitivity of 100%, 80. 0%, 100%, respectively. The accuracy of staging was 100% compared with the pathological diagnosis using these clinical staging system, which was superior to the accuracy of tumor stage by CT scan （stage Ⅰ 100%, stage Ⅱ 85.0%, stage Ⅲ 85.0%, and stage Ⅳ 75. 0%, respectively）. Conclusions The specific serum protein markers can give more information to identify nephroblastoma＇s clinical stage, and formulate the reasonable therapeutic plan.

关 键 词：肾母细胞瘤 质谱法 肿瘤分期 生物学标记 

分 类 号：R686[医药卫生—骨科学]