[Proteomic analysis in combination with CT diagnosis to distinguish renal cell carcinoma from renal benign masses].

OBJECTIVE

To identify the proteomic differences between renal cell carcinoma (RCC) and renal benign masses and to evaluate the diagnostic value of parallel and serial test combining with CT and surface enhanced laser desorption/ionization-time of flight-mass spectrometry (SELDI-TOF-MS).

METHODS

Serum samples were collected from 96 patients with renal tumors, 62 RCC cases and 34 renal benign mass cases, all of which had been evaluated by CT before surgery. The sera were analyzed using IMAC-Cu2+ ProteinChip system by SELDI-TOF-MS. The decision tree was generated by Biomark Pattern based on the sera of 42 RCC cases and 22 renal benign mass cases and was blind-tested by the rest sera samples. The parallel method and serial method combining CT and SELDI were also used to distinguish RCC and renal benign masses.

RESULTS

The sensitivity and specificity of the decision tree were 85.7% (36/42) and 90.9% (20/22) respectively. The sensitivity and specificity of the double-blind test were 75.0% (15/20) and 83.3% (10/12) respectively. CT showed higher sensitivity but lower specificity in detecting RCC. While combining CT with SELDI-TOF-MS, the sensitivity and specificity could be improved.

CONCLUSION

Three peaks with the molecular weights of 4657.56, 2955.95, and 3278.00 were detected which are potentially useful for differentiating RCC and renal benign masses. Using serial method combining CT and the decision tree based on these three proteins improves the sensitivity and positive predictive values of diagnosing RCC to 100%.