目的:筛选、鉴定乙型肝炎病毒(HBV)相关肝癌的血清差异表达蛋白,探讨其可能的早期诊断价值。方法:采用蛋白芯片及表面增强激光解析电离飞行时间质谱(surface-enhanced laser desorption/ionization time-of-flight mass spectrometry,SELDI-TOF-MS)技术对正常人、HBV相关肝炎、肝硬化患者及原发性肝癌患者术前血清分别进行检测,筛选肝癌血清差异表达蛋白;通过离子交换柱分离纯化其中表达差异最明显的蛋白,并进行质谱鉴定。根据筛选结果,建立肝癌诊断决策树模型,评价其诊断肝癌的准确性和敏感度。结果:与正常组相比,肝癌组有44个差异蛋白质波峰(P<0.05),其中21个上调,23个下调;与肝硬化组相比,肝癌组有51个差异蛋白质波峰(P<0.05),其中47个上调,4个下调。质荷比为5805的蛋白质表达在正常人群<慢性肝炎组<肝硬化组<肝癌组,在肝癌组中表达最高,差异具有统计学意义(P<0.01);对其酶解消化产物进行肽指纹谱(PMF)鉴定发现其中有2条肽段序列与硫酸软骨素合酶Ⅱ部分序列相匹配。根据筛选的差异表达蛋白成功建立肝癌诊断决策树模型,其判断肝癌的准确率为94.82%[(23+32)/58]、敏感性88.46%(23/26)、特异性100%(32/32)。结论:成功筛选HBV相关肝癌血清差异表达蛋白,其中差异最显著蛋白(质荷比为5805)酶解产物中有2条肽段与硫酸软骨素合酶Ⅱ部分序列相匹配;根据筛选结果建立的肝癌诊断决策树模型有助于早期诊断HBV相关肝癌。 Objective: To screen and identify differentially expressed proteins in serum of patients with hepatocellular carcinoma associated with Hepatitis B virus (HBV) and to explore the possible early diagnostic value. Methods: The expression profiles of human hepatitis B virus (HBV) -related hepatitis, cirrhosis and normal liver tissues were detected by protein chip and surface-enhanced laser desorption / ionization time-of-flight mass spectrometry (SELDI-TOF-MS) Preoperative serum of patients with hepatocellular carcinoma were detected, respectively, and screened for differentially expressed proteins in serum of hepatocellular carcinoma. The proteins with the most obvious difference were purified by ion exchange column and identified by mass spectrometry. According to the screening results, a diagnostic and decision tree model of liver cancer was established to evaluate the accuracy and sensitivity of the diagnosis of liver cancer. Results: There were 44 differential protein peaks (P <0.05) in HCC group, of which 21 were up-regulated and 23 were down-regulated. Compared with cirrhosis group, there were 51 differential protein peaks in HCC group (P <0.05) ), Of which 47 were up-regulated and 4 were down-regulated. The protein with mass-to-weight ratio of 5805 was expressed in normal group