CN106526028A - Applications of metabolic markers in diagnosing and identifying benign or malignant lesions of thyroid gland - Google Patents
Applications of metabolic markers in diagnosing and identifying benign or malignant lesions of thyroid gland Download PDFInfo
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Abstract
The invention discloses applications of metabolic markers in diagnosing and identifying benign or malignant lesions of thyroid gland. The malignant lesions of thyroid gland are used for referring thyroid cancer, and the benign lesions of thyroid gland are used for referring thyroid benign node; and the metabolic markers are 1-oleoyl-sn-glycerol-3-phosphatidylcholine and/or 1-stearoyl-sn-glycerol-3-phosphatidylcholine. It is confirmed that when 1-oleoyl-sn- glycerol-3-phosphatidylcholine and 1-stearoyl-sn-glycerol-3-phosphatidylcholine are used for diagnosing and identifying thyroid cancer and thyroid benign node separately, certain accuracy is achieved; and when 1-oleoyl-sn- glycerol-3-phosphatidylcholine and 1-stearoyl-sn-glycerol-3-phosphatidylcholine are used for diagnosing and identifying thyroid cancer and thyroid benign node together, higher accuracy is achieved; so that 1-oleoyl-sn- glycerol-3-phosphatidylcholine and 1-stearoyl-sn-glycerol-3-phosphatidylcholine, and a composition of 1-oleoyl-sn- glycerol-3-phosphatidylcholine and 1-stearoyl-sn-glycerol-3-phosphatidylcholine can be taken as the metabolic markers in diagnosing and identifying thyroid cancer and thyroid benign node.
Description
Technical field
The present invention relates to metabolism group, belongs to measurement field tests, and in particular to biological specimen small molecular metabolin
Qualitative and quantitative analysis and the application as metabolic markers in diagnosis different thyroid benign malignant change.
Background technology
Thyroid cancer is one of pernicious incretion tumour of modal incidence.Epidemiology survey finds, in the past
Decades in, there is the elevated phenomenon of thyroid cancer incidence in many cities all over the world.In Shanghai, investigation finds first shape
Gland cancer incidence of disease in masculinity and femininity rises 3.1% and 3.8% respectively；In Hong Kong, the incidence of disease rises 2.2% He respectively
2.7%；Then there is male sex's incidence of disease in the Queensland of Australia and rise 5.5%, the women incidence of disease rises 6.1% phenomenon
【Document 1：Time trends and age-period-cohort analyses on incidence rates of
thyroid cancer in Shanghai and Hong Kong,BMC Cancer,2014；Document 2：Increasing
thyroid cancer incidence in Queensland,Australia1982-2008-true increase or
over-diagnosis？Clinical Endocrinology,2016】.In document 2, author is proposed to the so high incidence of disease
Query, actually or the incidence of disease really rises and excessively to diagnose.
It is that the thyroid cancer generally acknowledged at present is aided in that Thyroid ultrasound is checked with fine needle aspiration biopsy (FNAB) under ultrasonic wave added
Diagnostic techniques, especially FNAB, it is referred to as the goldstandard of diagnosis of thyroid cancer.But studies have found that both detection methods
There is higher misdiagnosis rate, its diagnosis effect is not satisfactory.The inspection result of ultrasound is largely dependent upon examiner
Experience and the subjective factor such as technical merit, be thyroid cancer easily by benign thyroid nodules mistaken diagnosis.The result of mistaken diagnosis is exactly to increase
But the probability of non-essential thyroid operation treatment, the benign thyroid for finding to many B ultrasonic being not required to surgical procedure has been added to tie
Section has carried out unnecessary invasive treatment, increased medical treatment cost and the psychological burden of patient.Due to the limit of accuracy of sampling
System, FNAB are difficult to diagnose Mini-thyroid Cancer.FNAB is also difficult to differentiate between the good pernicious of Follicular tumor, causes more than 30% first
By FNAB methods, shape gland tubercle can not differentiate which is good pernicious, can only be made a definite diagnosis by operation.
Therefore, prior art distinguishes thyroid cancer in diagnosis and human thyroid benign nodules have obvious defect and deficiency.
Researchers have carried out the exploration of thyroid cancer specific biomarkers in many fields.Nikiforov,
Y.E. waiting carries out gene mutation site detection for the uncertain thyroid gland sample of property to 1056 FNAB diagnostic results, including
BRAF V600E, NRAS codon 61, HRAS codon 61 etc., as a result have found sample its tubercle that there is arbitrary gene mutation
Pernicious probability reaches more than 88%.Experiment to be concluded that and fail qualitatively thyroid needle tubercle for FNAB is checked, leads to
The detection for crossing gene mutation site is conducive to diagnosing tubercle property【Impact of mutational testing on
the diagnosis and management of patients with cytologically indeterminate
thyroid nodules:a prospective analysis of 1056FNA samples.J Clin Endocrinol
Metab,2011】.Chia, S.Y. etc. are had found to the TH in patient's blood circulation in studying to differentiated thyroid carcinoma
Value of the measure of hormone receptor (TSHR) mRNA (mRNA) content with auxiliary FNAB diagnosis.For FNAB cannot be differentiated
Thyroid nodule, which can be differentiated using TSHR mRNA, diagnostic sensitivity and specificity are up to 90% and 80%.Additionally,
Also can use whether the index prediction postoperative patient has cancerization remaining and transfer【Thyroid-stimulating hormone
receptor messenger ribonucleic acid measurement in blood as a marker for
circulating thyroid cancer cells and its role in the preoperative diagnosis
of thyroid cancer.The Journal ofClinical Endocrinology and Metabolism,2007】。
Although many for the research of thyroid cancer auxiliary diagnosis mark, not yet find at present diagnostic sensitivity and
The high unique identification thing of specificity or joint mark are applied to clinical diagnosis.Inventor place seminar passes through metabolism group
Method searched out for the diagnosis marker to diagnosis of coronary heart disease parting, correlative study achievement obtains international endorsement, sends out
Table is on periodical JAm Coll Cardiol. (factor of influence 17.759) that international cardiovascular field is ranked the first
(Comprehensive Metabolomic Characterization ofCoronaryArtery Diseases.JAm
Coll Cardiol.2016Sep 20；68(12):1281-93).This problem attempts to the research method of metabolism group to seek
The biomarker that can be used for diagnosis different thyroid benign malignant change is looked for, to overcome prior art thyroid cancer to be distinguished in diagnosis
With the defect and deficiency in terms of human thyroid benign nodules.
The content of the invention
It is an object of the invention to provide application of one group of metabolic markers in diagnosis different thyroid benign malignant change,
To overcome defect and deficiency of the prior art in terms of thyroid cancer and human thyroid benign nodules are distinguished in diagnosis.
Above-mentioned purpose is achieved by the following technical solution：
Application of the metabolic markers in diagnosis different thyroid benign malignant change, thyroid gland malignant change refer to thyroid gland
Cancer, benign thyroid lesions refer to human thyroid benign nodules, and the metabolic markers are 1- oleoyl-sn-glycero -3- phosphatid ylcholines
Or -3 phosphatid ylcholine of 1- stearoyl-sn- glycerine.Compared with human thyroid benign nodules patient, the two difference metabolins are in first
Expression in shape adenocarcinoma patients' blood plasma lowers 0.6～0.7 times.Receiver operating curves' method (ROC) proves, 1- oleoyls-
Sn- glycerine -3- phosphatid ylcholines, -3 phosphatid ylcholine of 1- stearoyl-sn- glycerine are individually used for diagnosis and distinguish thyroid cancer and first
During shape gland benign protuberance, with certain degree of accuracy (AUC ＞ 0.8).
Preferably, the metabolic markers be 1- oleoyl-sn-glycero -3- phosphatid ylcholines and 1- stearoyl-sn- glycerine -
The combination of 3 phosphatid ylcholines.Receiver operating curves' method (ROC) proves that 1- oleoyl-sn-glycero -3- phosphatid ylcholines and 1- are hard
- 3 phosphatid ylcholine of acyl-sn- glycerine is combined for diagnosing when differentiation thyroid cancer and human thyroid benign nodules, with higher
The degree of accuracy (AUC ＞ 0.9 in training set；In test set, 0.85), during than being used alone, the degree of accuracy is high for AUC ＞.
The thyroid cancer is papillary thyroid carcinoma.
The metabolic markers come from blood plasma.
Examination containing -3 phosphatid ylcholine of 1- oleoyl-sn-glycero -3- phosphatid ylcholines and/or 1- stearoyl-sn- glycerine
The application of agent box or diagnostic reagent in diagnosis different thyroid benign malignant change；Thyroid gland malignant change refers to thyroid cancer, first
Shape gland benign lesion refers to human thyroid benign nodules.
Beneficial effects of the present invention：
Present invention demonstrates that 1- oleoyl-sn-glycero -3- phosphatid ylcholines, -3 phosphatid ylcholine list of 1- stearoyl-sn- glycerine
When being solely used in diagnosis differentiation thyroid cancer and human thyroid benign nodules, with certain degree of accuracy；The two is combined for diagnostic region
When dividing thyroid cancer and human thyroid benign nodules, with the higher degree of accuracy.1- oleoyl-sn-glycero -3- phosphatid ylcholines, 1-
- 3 phosphatid ylcholine of stearoyl-sn- glycerine and combinations thereof can be used as diagnosis different thyroid cancer and human thyroid benign nodules
Metabolic markers.
Specific embodiment
Technical scheme is introduced specifically with reference to embodiment.
First, object and method
1st, sample clinical characters and collection
Jing after patient agrees to, Jiangsu Prov. People's Hospital 145 thyroid benign knots of in September, 2014～2015 year October are collected
Section patient and the peripheric venous blood blood plasma of 285 thyroid cancer patients.Human thyroid benign nodules patient includes nodositas thyroid gland
Swollen patient and Treatment of Benign Tumor of Thyroid Gland patient, thyroid cancer patients are papillary thyroid carcinoma patient, and equal Jing postoperative pathologicals make a definite diagnosis.
The age of human thyroid benign nodules patient and thyroid cancer patients, sex match.It is empty that all sample blood sampling times are early morning
Abdomen.
2nd, training set and test set
83 human thyroid benign nodules and 148 thyroid cancer patients blood plasma are randomly choosed as training set, to find first
The difference metabolin of shape gland cancer and human thyroid benign nodules；Remaining 62 human thyroid benign nodules and 137 thyroid cancer patients
Blood plasma as test set, for verifying difference metabolin as the ability of metabolic markers Diagnosis of Thyroid Carcinoma.
3rd, main agents
Acetonitrile and formic acid (UPLC is pure) are purchased from ROE companies of the U.S.；Chromatogram rank methyl alcohol and chloroform are purchased from Jiangsu Chinese nation science and technology
Co., Ltd；Chlorination methoxamine and N- methyl-N- (trimethyl silane) trifluoroacetamides (containing 1% trim,ethylchlorosilane) are purchased from U.S.
Sigma-Aldrich companies of state；MIlli-Q ultrapure water system system of the deionized water by U.S. Mi Libo (Millipore) company
It is standby；Standard items are purchased from U.S. Sigma-Aldrich.
4th, the sign (UPLC-Q/TOF-MS methods) of blood plasma difference metabolin
4.1 sample preparation
Sample treatment：100 μ L blood plasma are taken in 1.5mL centrifuge tubes, 400 μ L methyl alcohol are added, are mixed after being vortexed 30 seconds,
13000rpm × 10min is centrifuged (4 DEG C), takes 200 μ L of supernatant in 1.5mL centrifuge tubes, is dried up with Nitrogen evaporator at room temperature, gained
Residue 20% acetonitrile solution of 300 μ L dissolves, and obtains final product.
Sample Quality Control solution：10 μ L of each sample mixings are taken, pre-treatment is carried out as stated above, is obtained final product.Before sample analysis
Continuously 9 Quality Control solution of detection, start to analyze sample after instrument stabilizer, every Quality Control solution of 9 pattern detections.Per 9
Insert after individual pattern detection blank, it is to avoid cross pollution.
4.2UPLC-Q/TOF-MS chromatographic condition：
Chromatographic isolation adopts Ultra Performance Liquid Chromatography (UPLC, Agilent 1290, USA).Chromatographic column is Waters BEH
C18 posts (100mm × 2.1mm, 1.7 μm), 25 DEG C of column temperature, sample introduction room temperature be room temperature, 2 μ L of sample size.Positive and negative ion pattern stream
Dynamic phase composition is that A is 0.1% aqueous formic acid of volumetric concentration, and B is 0.1% formic acid acetonitrile solution of volumetric concentration.Gradient elution
Condition：0～1min is 0～30%B phases, and in 2min, B is phase linear increases to 60%, 3～8min linear changes to 90%B phases, so
100%B phases are linearly increasing in 8～9min afterwards and 1min is kept；Flow velocity 0.3mL/min, after post, efflux is direct without shunting
Import mass spectrometer system detection.
Mass spectral analysis adopts level Four bar-flight time mass spectrum (Agilent 6530Q-TOF/MS, USA).With electron spray from
Component (ESI) positive and negative ion mode detection；Dry gas stream speed is 7L/min, is dried temperature degree for 300 DEG C, is dried gas and taper hole
Gas is high pure nitrogen；100 DEG C of ion source temperature, under cation and negative ion mode, capillary voltage is 3000V, collision electricity
Press as 100V；Three secondary data collections, quality of scanning scope are carried out using full scan pattern is per second：M/z 100-1000 dalton.
5th, data processing and analysis
The training set sample data that above-mentioned UPLC-Q/TOF-MS is obtained is changed into after mz.data forms, with R platforms is
Running environment, extracts data using XCMS packets, completes spectral peak identification, filters the pre-treatment program such as hot-tempered, finally exports three-dimensional square
Battle array, i.e., index (variable), sample names and peak intensity/area by the spectral peak that retention time and karyoplasmic ratio are constituted.The number that will be obtained
Multivariate statistics soft sim CA (version 13.0.2, Umetrics) is imported according to matrix carries out multi-variate statistical analysis.By building
Friendship ginsenoside (OPLS-DA) model of attentioning obtains VIP values, and is carried out using SPSS statistics softwares many
Check analysis again, finds metabolic profile between thyroid cancer and human thyroid benign nodules and contributes larger (VIP ＞ 1.0 and p ＜
0.01) metabolin as characterizes the difference metabolin of thyroid cancer.
6th, the identification of difference metabolite：The coverage rate for passing through to have built up by the difference metabolin ion that training set is obtained
Reach Information in Mass Spectra storehouse, the HMDB (http of 2000 metabolins://www.hmdb.ca/) and Metline (http://
) etc. metlin.scripps.edu/ database carries out the retrieval of the structure of matter, using the accurate molecular weight provided in database and
The structure of the above-mentioned difference metabolin of MS/MS collection of illustrative plates Preliminary Identifications obtained by mass spectrum.Metabolite reference substance storehouse is utilized finally, with mark
The molecular weight of quasi- product, chromatographic retention and corresponding multistage MS fragmentation patterns are compared, so as to confirm the structure of difference metabolin.
7th, difference metabolin diagnostic is evaluated (be based on training set)
In training set, using receiver operating curves' method (ROC) inspection difference metabolin diagnosis distinguish thyroid cancer and
The degree of accuracy of human thyroid benign nodules.In Receiver operating curve's evaluation method, area (AUC) value under ROC curve exists
In the case of 0.5,1 is closer to, illustrates that diagnosis effect is better.AUC has relatively low accuracy at 0.5～0.7, and AUC exists
There is certain accuracy when 0.7～0.9, when AUC is more than 0.9, have high accuracy.
8th, difference metabolin diagnostic is evaluated (be based on test set)
In test set, first shape is distinguished using receiver operating curves' method (ROC) inspection difference metabolin diagnosis further
The degree of accuracy of gland cancer and human thyroid benign nodules.
2nd, result
Thyroid cancer and thyroid gland are distinguished using the inspection difference metabolin diagnosis of receiver operating curves' method in training set
During the degree of accuracy of benign protuberance, there is the AUC of two independent difference metabolins more than 0.8, respectively：1- oleoyl-sn-glyceros-
3- phosphatid ylcholines, -3 phosphatid ylcholine of 1- stearoyl-sn- glycerine.Compared with human thyroid benign nodules patient, the two differences
Expression of the metabolin in thyroid cancer patients blood plasma is lowered (to be proved to lower 0.6～0.7 by standard items quantitative determination
Times).1- oleoyl-sn-glycero -3- phosphatid ylcholines, 1- stearoyl-sn- -3 phosphatid ylcholines of glycerine are single to be distinguished for diagnosing
Thyroid cancer is stronger with the ability of human thyroid benign nodules, the TG-AUC of 1- oleoyl-sn-glycero -3- phosphatid ylcholines
(AUC) it is 0.899, under optimal cutoff values, sensitivity and specificity are respectively 68.9% and 95.2%, 1- stearoyl-sn-
The AUC of -3 phosphatid ylcholine of glycerine is 0.879, and under optimal cutoff values, sensitivity and specificity are respectively 79.7% He
84.3%；When the two is combined for diagnosing, up to 0.906, under optimal cutoff values, sensitivity and specificity are respectively AUC
77.7% and 88.0%.AUC the results are shown in Table 1.
Thyroid cancer and thyroid gland are distinguished using the inspection difference metabolin diagnosis of receiver operating curves' method in test set
During the degree of accuracy of benign protuberance, 1- oleoyl-sn-glycero -3- phosphatid ylcholines, -3 phosphatid ylcholine list of 1- stearoyl-sn- glycerine
Individual AUC is all higher than 0.83；1- oleoyl-sn-glycero -3- phosphatid ylcholines and -3 phosphatid ylcholine of 1- stearoyl-sn- glycerine connection
Up to 0.852, under optimal cutoff values, sensitivity and specificity are respectively 75.7% and 84.2% to the AUC of conjunction.AUC results are shown in
Table 2.
AUC result of the table 1 based on training set
AUC result of the table 2 based on test set
It is above-mentioned test result indicate that：1- oleoyl-sn-glycero -3- phosphatid ylcholines, -3 phosphatidyl of 1- stearoyl-sn- glycerine
When choline is individually used for diagnosis differentiation thyroid cancer and human thyroid benign nodules, with certain degree of accuracy；The two is combined is used for
When thyroid cancer and human thyroid benign nodules are distinguished in diagnosis, with the higher degree of accuracy.1- oleoyl-sn-glycero -3- phosphatidyl courages
Alkali, -3 phosphatid ylcholine of 1- stearoyl-sn- glycerine and combinations thereof can be used as diagnosis different thyroid cancer and thyroid benigns
The metabolic markers of tubercle.
The effect of above-described embodiment indicates that the essentiality content of the present invention, but does not limit the protection of the present invention with this
Scope.Technical scheme is modified or equivalent without departing from technical solution of the present invention essence and protection model
Enclose.
Claims (5)
1. application of the metabolic markers in diagnosis different thyroid benign malignant change, thyroid gland malignant change refer to thyroid cancer,
Benign thyroid lesions refer to human thyroid benign nodules, it is characterised in that：The metabolic markers are 1- oleoyl-sn-glycero -3- phosphorus
- 3 phosphatid ylcholine of phosphatidylcholine or 1- stearoyl-sn- glycerine.
2. application of the metabolic markers according to claim 1 in diagnosis different thyroid benign malignant change, its feature
It is：The metabolic markers are -3 phosphatidyl courage of 1- oleoyl-sn-glycero -3- phosphatid ylcholines and 1- stearoyl-sn- glycerine
The combination of alkali.
3. application of the metabolic markers according to claim 1 and 2 in diagnosis different thyroid benign malignant change, which is special
Levy and be：The thyroid cancer is papillary thyroid carcinoma.
4. application of the metabolic markers according to claim 1 and 2 in diagnosis different thyroid benign malignant change, which is special
Levy and be：The metabolic markers come from blood plasma.
5. the reagent containing -3 phosphatid ylcholine of 1- oleoyl-sn-glycero -3- phosphatid ylcholines and/or 1- stearoyl-sn- glycerine
The application of box or diagnostic reagent in diagnosis different thyroid benign malignant change；Thyroid gland malignant change refers to thyroid cancer, first shape
Gland benign lesion refers to human thyroid benign nodules.
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| CN111999404A (en) * | 2020-08-14 | 2020-11-27 | 中元伯瑞生物科技(珠海横琴)有限公司 | Application of nervonic acid in preparation of detection reagent for thyroid malignant tumor |
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