类风湿关节炎患者血清蛋白质指纹图谱分析  

Analysis of serum proteomic patterns in patients with rheumatoid arthritis

作　　者：陈勤[1] 薛静[2] 戴宇[1] 黄永禄[1] 余捷凯[3] 张松照[1] 

机构地区：[1]浙江大学医学院附属第二医院检验科,杭州310009 [2]浙江大学医学院附属第二医院风湿科,杭州310009 [3]浙江大学医学院附属第二医院肿瘤研究所,杭州310009

出　　处：《临床检验杂志》2009年第5期370-372,共3页Chinese Journal of Clinical Laboratory Science

基　　金：浙江省教育厅课题(20061404)

摘　　要：目的用表面增强激光解吸离子化飞行时间质谱(SELDI-TOF-MS)技术检测类风湿关节炎(RA)患者血清蛋白质指纹图谱,初步探讨筛选差异性蛋白建立的诊断模型对RA的诊断和治疗的意义。方法用SELDI-TOF-MS技术及CM10蛋白质芯片检测12例RA患者甲氨碟呤(MTX)治疗前后和12例非RA患者的血清蛋白质指纹图谱,经分析处理数据和筛选标志物,建立诊断模型。用此模型同时盲法检测RA和非RA患者各40例。结果有5个蛋白质峰(4198、4159、4221、4654和4238m/z)组合构建的诊断模型鉴别RA和非RA疾病的敏感性为91.7%(11/12),特异性为83.3%(10/12)。扩大样本盲法验证结果,其敏感性为87.5%(35/40),特异性为92.5%(37/40)。3个蛋白质峰(4071、5579和9246m/z)组合的模型最能反映RA患者MTX治疗前后血清蛋白质的差异,其敏感性和特异性均为91.7%(11/12)。结论建立的血清蛋白质指纹图谱诊断模型对RA的筛查、早期诊断及疗效监测有一定价值,应进一步深入研究。Objective To detect the serum proteomic patterns in rheumatoid arthritis （RA） patients by SELDI-TOF-MS protein chip array technology,and to screen candidate biomarkers,build diagnostic models and evaluate its clinical significance. Methods SELDI- TOF-MS and CM10 protein chip were used to detect the serum proteomic patterns of 12 patients with RA before/after MTX therapy and 12 patients with non-RA. The diagnostic models were developed and validated by a large scale blind test. Results The model composed of five protein peaks （4 198,4 159,4 221,4 654,and 4 238 m/z） could be the best for differentiating RA from non-RA diseases. Its sensitivity and specificity were 91.7% （11/12） and 83.3% （10/12） respectively. A sensitivity of 87.5% （35/40） and a specificity of 92.5% （37/40） in a large scale blind test were obtained. The model formed by three protein peaks （4 071,5 579and 9 246 m/z） could be the best to reflect the difference before and after MTX therapy. Its sensitivity and specificity were 91.7% （11/12） and 91.7% （11/12） respectively. Conclusions The method has great potential for the early diagnosis and evaluation after therapy and for screening novel and better biomarkers for RA.

关 键 词：类风湿关节炎 表面增强激光解吸离子化飞行时间质谱 蛋白质指纹图谱 

分 类 号：R446[医药卫生—诊断学]