胃肠肿瘤恶液质患者MyoDI表达及其临床意义

Clinical significance of expression of MyoDI in gastrointestinal carcinoma patients with cachexia

目的:检测胃肠肿瘤恶液质与胃肠良性病变营养不良患者外周血中肌源分化因子家族抑制因子(MyoDI)的表达,探讨胃肠肿瘤恶液质与胃肠良性病变营养不良的不同致病机制。方法:采用RT-PCR方法检测30例胃肠恶性肿瘤恶液质和30例胃肠良性病变营养不良患者静脉血中MyoDImRNA表达。对比分析MyoDImRNA表达与患者营养状态关系。结果:胃肠肿瘤恶液质组检测到MyoDImRNA表达者23例(23/30,76.7%),在胃肠良性病变营养不良组中,有8例患者检测到MyoDImRNA表达(8/30,26.7%),两者差异有显著意义(χ2=15.0166,P<0.01)。胃肠肿瘤恶液质组23例MyoDImRNA表达阳性者平均水平为1.83±0.91,胃肠良性病变营养不良组8例MyoDImRNA表达阳性者平均水平为1.32±0.43,两者差异有显著意义(t=2.1304,P<0.05)。两组患者全肠外营养(TPN)治疗4周后,胃肠良性病变营养不良组患者平均体重增加,血清白蛋白、转铁蛋白、总淋巴细胞数均有改善,胃肠肿瘤恶液质组患者营养状态指标无明显改善。结论:胃肠肿瘤恶液质患者MyoDI增强表达影响患者营养状态和TPN的治疗效果。

Objective To detect the expression of MyoDI in blood of patients with gastrointestinal malignancy eaehexia and benign malnutrition, and to study different molecular mechanisms between cancer eaehexia and benign malnutrition. Methods RT-PCR technique was used to assay the expression of MyoDI mRNA in peripheral venae blood from patients of gastrointestinal carcinoma and benign disease, 30 cases in each group. And the relation between MyoDI expression and gastrointestinal malignant eaehexia was analyzed. Results MyoDI mRNA expression was found in 23 eases ofgastrointestihal malignancy group （23/30, 76. 7% ）, and the expression level was 1.83 ± 0.91. 8 cases of MyoDI mRNA expression were found in gastrointestinal benign group （8/30,26. 7% ）, the average level was 1.32 ± 0.43. The difference of positive rates between two groups was significant （X^2 = 15. 0166, P 〈 0. 01 ）. And the level of MyoDI mRNA expression in the malignant group was higher than that in the benign group（ t = 2. 1304, P 〈 0. 05）. Nutritional state and MyoDI mRNA expression were observed after four weeks of TPN administration. The nutritional status, including weight, albumin, transferring, and total number of lymphocytes, were improved in the gastrointestinal benign group. But no any amelioration of nutritional status was observed in the group of gastrointestinal malignancy. Conclusion Expression of MyoDI had an adverse effect on nutritional status and TPN treatment in patients with gastrointestinal carcinoma.