Kim Yumi, Kang Un-Beom, Kim Sungsoo, Lee Han-Byoel, Moon Hyeong-Gon, Han Wonshik, Noh Dong-Young
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Daegu Gyeongbuk Institute of Science & Technology, Daegu, Korea.
J Breast Cancer. 2019 Dec;22(4):579-586. doi: 10.4048/jbc.2019.22.e57.
Currently, the standard screening tool for breast cancer is screening mammography. There have been many efforts to develop a blood-based diagnostic assay for breast cancer diagnosis; however, none have been approved for clinical use at this time. The purpose of this study was to determine the accuracy of a novel blood-based proteomic test for aiding breast cancer diagnosis in a relatively large cohort of cancer patients.
A blood-based test using multiple reaction monitoring (MRM) measured by mass spectrometry to quantify 3 peptides (apolipoprotein C-1, carbonic anhydrase 1, and neural cell adhesion molecule L1-like protein) present in human plasma was investigated. A total of 1,129 blood samples from 575 breast cancer patients, 454 healthy controls, and 100 patients with other malignancies were used to verify and optimize the assay.
The diagnostic sensitivity, specificity, and accuracy of the MRM-based proteomic assay were 71.6%, 85.3%, and 77%, respectively; the area under the receiver operating characteristic curve was 0.8323. The proteomic assay did not demonstrate diagnostic accuracy in patients with other types of malignancies including thyroid, pancreatic, lung, and colon cancers. The diagnostic performance of the proteomic assay was not associated with the timing of blood sampling before or after anesthesia.
The data demonstrated that an MRM-based proteomic assay that measures plasma levels of three specific peptides can be a useful tool for breast cancer screening and its accuracy is cancer-type specific.
目前,乳腺癌的标准筛查工具是乳腺钼靶筛查。人们已做出诸多努力来开发用于乳腺癌诊断的血液诊断检测方法;然而,目前尚无一种获得临床应用批准。本研究的目的是确定一种新型血液蛋白质组检测方法在相对较大规模的癌症患者队列中辅助乳腺癌诊断的准确性。
研究了一种基于血液的检测方法,该方法使用质谱法通过多反应监测(MRM)来定量人血浆中存在的3种肽(载脂蛋白C-1、碳酸酐酶1和神经细胞粘附分子L1样蛋白)。共使用了来自575例乳腺癌患者、454例健康对照和100例其他恶性肿瘤患者的1129份血样来验证和优化该检测方法。
基于MRM的蛋白质组检测方法的诊断敏感性、特异性和准确性分别为71.6%、85.3%和77%;受试者操作特征曲线下面积为0.8323。该蛋白质组检测方法在包括甲状腺癌、胰腺癌、肺癌和结肠癌在内的其他类型恶性肿瘤患者中未显示出诊断准确性。蛋白质组检测方法的诊断性能与麻醉前后采血时间无关。
数据表明,一种基于MRM的蛋白质组检测方法,可测量三种特定肽的血浆水平,可能是乳腺癌筛查的有用工具,且其准确性具有癌症类型特异性。