分析非小细胞肺癌(NSCLC)患者血清外泌体差异蛋白表达在临床诊断中的意义。

选择2017年1月至2018年1月新疆医科大学附属肿瘤医院肺内一科收治的NSCLC患者85例为NSCLC组，同期医院健康体检志愿者50例为对照组，利用蛋白组学技术筛选出两组患者血清外泌体中表达差异性最大的蛋白，采用Western blot与酶联免疫吸附法检测其在NSCLC患者中的表达水平，分析在诊断NSCLC中的应用价值。

NSCLC组患者血清外泌体总蛋白质平均浓度显著高于对照组(t＝18.723，P＝0.000)；两组血清外泌体中TMEM88蛋白表达量差异显著，Gel-Pro软件定量分析血清外泌体TMEM88蛋白条带积分光密度值(IOD)，提示NSCLC患者血清外泌体中TMEM88蛋白质表达水平显著高于对照组(t＝13.316，P＝0.000); NSCLC患者在肿瘤Ⅲ~Ⅳ期、有淋巴结转移及有血管癌栓中血清外泌体来源TMEM88蛋白表达升高(t＝7.376、3.958、4.304，P＝0.000)；血清来源外泌体TMEM88蛋白表达超过589.41时，诊断NSCLC的AUC＝0.787，灵敏度及特异度分别为74.1%和87.1%，约登指数为0.612。

NSCLC患者血清外泌体来源TMEM88蛋白表达量异常升高，表达量与患者肿瘤分期、淋巴转移、脉管癌栓及肿瘤负荷量有关，在NSCLC诊断中有临床意义。

To analyze the clinical value of differential protein expression of serum exosomes in patients with non-small cell lung cancer (NSCLC).

All of 85 NSCLC patients and 50 healthy individuals in Affiliated Tumor Hospital of Xinjiang Medical University from January 2017 to January 2018 were enrolled, and set as NSCLC group and control group, respectively. Proteomic techniques were used to screen out the differentially expressed proteins in serum exosomes between healthy controls and NSCLC patients; Western blot and enzyme-linked immunosorbent assay were used to detect the expression level of the proteins in NSCLC patients, and its relationship with clinical features and its diagnostic value in NSCLC patients were discussed.

The total protein of serum exosomes in NSCLC patients was significantly higher than that in healthy controls (t=18.723, P=0.000). Proteomics analysis revealed that the expression of TMEM88 protein in serum exosomes had significant difference between healthy controls and NSCLC patients. Gel-Pro software was used to quantitatively analyze the integrated optical density (IOD) value of serum exosomes TMEM88 protein bands, suggesting that the TMEM88 protein expression level in serum exosomes of NSCLC patients was significantly higher than that in healthy controls (P<0.05). Analysis showed that tumor staging, lymph node metastasis and vascular tumor thrombus in NSCLC patients affected the expression of TMEM88 protein derived from serum exosomes (P<0.05); ROC curve found that the AUC, sensitivity and specificity of TMEM88 protein derived from serum exosomes in the diagnosis of NSCLC were 0.787, 74.1% and 87.1% when its value exceeded 589.41.

The expression level of serum exosome-derived TMEM88 protein in NSCLC patients is abnormal, and its expression level is related to tumor stage, lymphatic metastasis, vascular cancer thrombus and tumor load, indicating that TMEM88 protein has a good efficacy in the clinical diagnosis and prognosis evaluation of NSCLC.