The Preliminary Research Of Serum Proteomics In Periampullary Cancer Based On SELDI-TOF-MS

Objective： Periampullary carcinoma includes ampullary cancer,the terminal bile duct carcinoma and the duodenum cancer. All kinds ofperiampullary carcinoma have different biological characteristics andprognosis after surgery.At the same time, we often confuse periampullarycarcinoma and the head of pancreas cancer，which have significantdifferences on biological characteristics and prognosis.So we compareeach serum protein spectra of periampullary carcinoma and the head ofpancreas cancer based on SELDI-TOF-MS technology,explore differentserum protein among those carcinomas，screen the tumor markers ofampullary carcinoma based on the difference proteomics, and establishdecision-making tree diagnosis model, expecting to find early diagnosismethod of the ampullary carcinoma.Method： Use surface-enhanced laser desorption ionization flighttime mass spectrometry (SELDI-TOF-MS) technology to test the serumof histopathologically confirmed27cases ampullary carcinoma，12casesthe terminal bile duct cancer，34cases the head of pancreas cancer and30cases normal control group. Use Biomaker Wizard version3.1softwareanalysis the results to screen the statistically significant differencesprotein. Apply Paired comparison approach to compare ampullary carcin- oma, the head of pancreas cancer and the terminal bile ductcarcinoma, explore whether there are differences between each other. Weuse SPSS17.0software to establish decision tree diagnosis model aboutampullary carcinoma and apply ROC curves to compare diagnosticvalue.At last,we retrieve differential proteins through the protein databasein order to preliminarily identify differential protein.Result:1.There are differential serum proteins among ampullarycarcinoma，the head of pancreas cancer and the terminal bile duct cancer2.There are32significant differential protein peaks (P <0.05) betweenampullary carcinoma and the normal control group. ampullary carcinomahave10relative higher serum protein and22relative lower proteincompared to normal control group. there are14significant differentialproteins peaks (P <0.05) between ampullary carcinoma and the head ofpancreas cancer. Ampullary carcinoma have1relative higher serumprotein and13relative lower proteins compared to the head of pancreascancer. ampullary carcinoma have6relative higher serum proteins and2relative lower proteins compared to the terminal bile duct cancer. Theterminal bile duct cancer has18relative lower proteins compared to thehead of pancreas cancer.3.Use ROC curves evaluate the differentialdiagnosis value of CA19-9, when boundary of CA19-9is47.9u/ml,thereis maximum diagnostic value with the specificity66.7%and sensitivity70.4%respectively.4.The area under the ROC curves of the decision tree diagnosis model,CA19-9, M/Z8612, M/Z6583is0.861,0.685,0.787,0.708respectively. The decision tree diagnosis model has the bestdiagnosis effect.5.Use TagIdent search tool to retrieve M/Z6583,M/Z8612in the Swiss-Prot protein database and obtain two kind ofcandidate proteins and four kind of candidate proteins respectively.Conclusion：1.The results indicate there are difference about theserum protein among the ampullary carcinoma、terminal bile duct cancerand the head of pancreas cancer. Screening the differential expressionprotein avail to further explore the molecular basis of the differencesprognosis.2.There are serum protein fingerprint differences betweenampullary cancer and the control group，M/Z6583and M/Z8612havebetter diagnosis effect than traditional tumor markers CA19-9.Furtherresearch will benefit the differential diagnosis of ampullary cancer andunderstand the occurrence and development process of ampullarycancer.3.The decision tree diagnosis model has high diagnostic value.Thearea under the ROC curves of the decision tree diagnosis model, CA19-9,M/Z6583, M/Z8612were0.861,0.685,0.787,0.708respectively. Thedecision tree diagnosis model has good clinical value. It may become anew method of screening ampullary.