基于血清肽组学的甲状腺癌术后风险实时评估标志物研究

血清甲状腺球蛋白水平是目前评价甲状腺癌术后肿瘤残留及监测病情变化的重要指标，但由于血清甲状腺球蛋白抗体的存在会干扰检测结果导致假阳性或假阴性，造成对术后病人错误的临床风险分级，从而导致过度治疗或治疗不足。因此，寻找甲状腺癌术后实时的肿瘤残留监测、复发及转移风险评估标志物具有重大意义。我们在前期研究中建立了血清小分子多肽的基质辅助激光解吸电离飞行时间质谱快速检测方法，并发现血清中的小分子缓激肽水平与甲状腺癌病人术前、术后肿瘤负荷正相关，有望成为甲状腺癌术后监测和风险评估的有效标志物。本研究拟在此基础上优化缓激肽的检测方法，并进行不同人群的临床大样本验证，研究该标志物的特异性和灵敏度，及其在术后长期随访中的预警作用。可望为发展甲状腺癌病人术后病况实时监测、精准诊断和治疗奠定基础，并为长期随访提供新的手段。

Serum thyroglobulin measurement has been occurred owing to its role as a marker in detecting the presence or residual, recurrence or metastases in patients with differentiated thyroid cancer (DTC) after total or near-total thyroidectomy. In many cases, these immunoassays could be affected by anti-Tg autoantibodies result in falsely measurements. Therefore, there has been an urgent need in an individualized approach for DTC patients, centered in tumor biomarkers for risk stratification especially after total thyroidectomy or lobectomy. Previously, we developed a novel matrix-assisted laser desorption/ionization time-of flight-mass spectrometry based method for serum peptidome signature identification. We found serum kinins levels were correlated with the pre- and postoperative tumor burden in DTC patients. In this proposal, we will optimize and validate this method and propose to use the information provided by biofunctional peptides circulating in the bloodstream for an individualized approach as well as long-term risk stratification for DTC patients after total thyroidectomy.