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目的筛选肝细胞癌门静脉癌栓形成相关的血清蛋白质分子标记物并建立预测模型。方法收集135例肝细胞癌患者血清,95例(其中33例为肝细胞癌伴门静脉癌栓,62例为肝细胞癌不伴门静脉癌栓)为建模型组,40例(其中18例为肝细胞癌伴门静脉癌栓,22例为肝细胞癌不伴门静脉癌栓)为盲法验证组,采用弱阳离子交换蛋白质芯片(WCX2)为检测介质,经表面加强激光解吸电离飞行时间质谱(SELDITOFMS)测定得到蛋白质谱,通过BioMarkerWizardSoftware比较两组患者血清蛋白质谱,利用BiomarkerPatternsSoftware建立决策树模型并进行盲法验证。结果在m/z1100～30000范围内,检测出的100个蛋白峰中16个蛋白峰有显著差异(P<0.01),m/z为3478、1314、1744、1725、2022和3380的蛋白峰在肝细胞癌伴门静脉癌栓组中上调,而m/z为8901、9353、9415、8773、2766、2745、8697、7773、8569和1373的蛋白峰在肝细胞癌伴门静脉癌栓组中下调;选择m/z为3478、2022、8901、9415、8773、2766、和2745的7个蛋白峰建立的决策树模型其敏感性为75.8%(25/33),特异性为82.3%(51/62);盲法验证该模型准确率87.5%(35/40),灵敏性100%(18/18),特异性77.3%(17/22),阳性预测值78.3%(18/23),阴性预测值100%(17/17)。结论筛选出的16个蛋白分子标记物可能与肝细胞癌门静脉癌栓形成有关;决策树模型可能对预测肝细胞癌门静脉癌栓的发生有重要的临床意义。
Objective To screen serum protein molecular markers associated with portal vein thrombosis in hepatocellular carcinoma and to establish a predictive model. Methods Seventy-five patients with hepatocellular carcinoma (HCC) were enrolled in this study. Serum samples were collected from 95 patients (33 hepatocellular carcinoma with portal vein tumor thrombus and 62 with hepatocellular carcinoma without portal vein tumor thrombus) as model group. Forty patients (18 were liver 22 cases of hepatocellular carcinoma without portal vein tumor thrombus were blinded validation group. The weak cation exchange protein chip (WCX2) was used as the detection medium. The surface enhanced laser desorption / ionization time of flight mass spectrometry (SELDITOFMS) The protein profiles were determined. The serum protein profiles of two groups were compared by BioMarker Wizard Software. The decision tree model was established by Biomarker Patterns Software and the blind validation was performed. Results In the range of m / z 1100 ~ 30000, there were significant differences (P <0.01) in 16 protein peaks among the 100 protein peaks detected. The protein peaks at m / z 3478, 1314, 1744, 1725, Hepatocellular carcinoma with portal vein tumor thrombosis group increased, and m / z 8901,9353,9415,8773,2766,2745,8697,7773,8569 and 1373 protein peak in hepatocellular carcinoma with portal vein tumor thrombosis decreased; In the decision tree model with seven protein peaks of m / z 3478, 2022, 8901, 9415, 8773, 2766 and 2745, the sensitivity was 75.8% (25/33) and the specificity was 82.3% (51/62 ). The accuracy of the model was 87.5% (35/40), 100% (18/18), 77.3% (17/22), and 78.3% (18/23) respectively. The negative predictive value Value 100% (17/17). Conclusion The 16 protein molecular markers screened out may be related to the formation of portal vein thrombosis in hepatocellular carcinoma. The decision tree model may have important clinical significance in predicting the occurrence of portal vein tumor thrombus in hepatocellular carcinoma.