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目的:探讨应用血清多肽谱图分析宫颈上皮内瘤样病变(CIN)的血清多肽谱图的变化,寻找预测CIN转归的方法。方法:使用基质辅助激光解吸附电离串联飞行时间质谱技术(MALDI-TOF-MS),选用磁珠检测34例宫颈鳞癌患者、31例健康女性和128例CIN患者的血清多肽学谱图,建立宫颈鳞癌的诊断模型。分析血清多肽谱图与CIN转归的关系。结果:建立宫颈鳞癌的血清多肽谱图诊断模型,盲筛验证模型敏感性92.9%(13/14),特异性100.0%(14/14),阳性预测值96.4%。CIN级别升高其血清多肽谱图进入宫颈鳞癌模型的数量增加,CIN1组(74.4%)和CIN3组(12.5%)比较差异有统计学意义,P<0.01。随访18～24个月,进入鳞癌组CIN病变加重的比例高于后者(35.7%vs 12.2%,P<0.05),病变好转的概率低于后者(7.1%vs 44.9%,P<0.01)。结论:根据血清多肽学谱图进行分类,可将CIN分为高危和低危组,预测其转归,为制定CIN患者的个体化治疗方案提供依据。
Objective: To investigate the change of serum polypeptide profile of cervical intraepithelial neoplasia (CIN) by using serum peptide profiles and to find a method to predict the prognosis of CIN. METHODS: Serum peptides from 34 patients with cervical squamous cell carcinoma, 31 healthy women and 128 patients with CIN were detected by magnetic beads using matrix-assisted laser desorption / ionization tandem time of flight mass spectrometry (MALDI-TOF-MS) Cervical squamous cell carcinoma diagnosis model. Analysis of the relationship between serum peptide profiles and CIN outcome. Results: The diagnosis of cervical squamous cell carcinoma was established. The sensitivity of blind screening test was 92.9% (13/14), specificity was 100.0% (14/14) and the positive predictive value was 96.4%. CIN level increased its serum peptide profile into the cervical squamous cell carcinoma model number increased, CIN1 group (74.4%) and CIN3 group (12.5%) difference was statistically significant, P <0.01. The follow-up of 18-24 months showed that the incidence of CIN in squamous cell carcinoma was higher than that of the latter (35.7% vs 12.2%, P <0.05), and the probability of improvement was lower than that of the latter (7.1% vs 44.9%, P <0.01) ). Conclusion: According to the classification of serum peptides, CIN can be divided into high-risk group and low-risk group, and prognosis of CIN can be predicted. It provides a basis for individualized treatment of CIN patients.