探讨鉴别诊断肺癌与肺感染患者的生物标志物  

Investigation of biochemical markers for the differential diagnosis between lung cancer and lung infection

作　　者：段红茹[1] 王庆艳 马玉株[1] 宋林[1] 葛鹏[1] 孙续国[1] 

机构地区：[1]天津医科大学医学检验学院,300203 [2]河北省唐山市丰润区医院,064000

出　　处：《实用医学杂志》2012年第3期473-476,共4页The Journal of Practical Medicine

基　　金：国家自然科学基金资助项目(编号:30973157)

摘　　要：目的:探讨肺癌与肺感染患者之间生化成分含量以及蛋白组学变化,用于筛选诊断恶性胸腔积液的生物标志物。方法:(1)分别测定肺癌和肺感染患者血清和胸腔积液总蛋白、白蛋白、甘油三酯等10项生化成分含量,进一步比较两组之间各项指标的胸腔积液与血清的比值。(2)基质辅助激光电离飞行时间质谱(MALDI-TOF-MS)分析TTR蛋白化学修饰。结果:(1)肺癌患者血清中CHO、ApoA-1、TTR蛋白含量明显高于肺感染患者;而肺感染患者胸腔积液中ADA的活性高于肺癌患者。(2)计算个体胸腔积液与血清生化成分含量比值,肺癌患者TTR蛋白比例显著高于肺感染患者,ADA减低,与血清变化趋势相同,但更加明显。(3)肺癌患者及肺感染患者血清TTR蛋白均出现3种修饰类型,而肺癌患者胸腔积液中cysgly-TTR明显增高。结论:联合分析胸腔积液与血清TTR蛋白的比值和化学修饰,可能有助于鉴别诊断肺癌与肺感染。Objective To investigate the difference of serum biochemical ingredients and proteomic changes between lung cancer and lung infection, and screen the biochemical markers for the diagnosis of malignant pleural effusion. Methods Concentrations of 10 kinds of biochemical ingredients [total protein （TP）, triglyeeride （TG）, lactic dehydrogenase （LDH） etc] in serum and pleural effusion in patients with lung cancer or lung infection were determined, and further, the ratio of all parameters between pleural effusion and serum of the two groups were calculated. Chemically modified TrR and ratio were analyzed by matrix-assisted laser ionization time of flight mass spectrometry （MALDI-TOF-MS）. Results As compared with those in patients with lung infection, serum levels of cholesterol （CHO）, apolipoprotein A （ApoA-1）, and transthyretin （TFR） were significantly higher in patients with lung cancer, while in pleural effusion samples, level of adenosine deamina （ADA） was obviously lower. The ratio of TrR was significantly higher in patients with lung cancer than that in patients with lung infection, while that of ADA was lower. In serum samples, 3 types of modified TFR were present in both lung cancer and lung infection patients; while in pleural effusion samples, cysgly-TTR was significantly increased in patients with lung cancer. Conclusions Combined analysis of chemical modification with ratio of TTR in pleural effusion and serum may be assisting the diagnosis for lung cancer or lung infection.

关 键 词：肺肿瘤 肺感染 转甲状腺素蛋白 胸腔积液 化学修饰 

分 类 号：R734.2[医药卫生—肿瘤]