胃癌患者血清总IgG浓度与肿瘤进展的关系

Relationship between total serum IgG concentration and tumor progression in patients with gastriccancer

目的 探讨胃癌患者血清总IgG浓度与肿瘤进展的关系。方法 选取2010年1月—2017年5月北京中医药大学孙思邈医院收治的90例胃癌患者作为研究对象，根据年龄特点和性别比例选取同时期体检的90例健康人群作为对照。应用酶联免疫吸附法测定血清IgG亚群和总IgG浓度。分析胃癌患者血清IgG浓度与临床病理特征的关系。通过免疫组织化学检测肿瘤组织和正常组织中CD138阳性的浆细胞的数量。结果 胃癌患者血清总IgG浓度显著低于对照组［（923.6±290.5）mg/dl∶（1 072.5±298.6）mg/dl］，差异有统计学意义（t=3.391，P=0.001）。胃癌患者血清总IgG及IgG1浓度均与淋巴结转移（t=3.585，P〈0.001；t=3.545，P〈0.001）、胃癌分期（t=3.669，P〈0.001；t=3.401，P〈0.001）相关。胃癌患者肿瘤部位CD138阳性的浆细胞数量明显低于正常胃黏膜组织［（88.7±31.9）个∶（108.5±33.4）个］，差异有统计学意义（t=2.778，P=0.007）。多变量分析表明，血清总IgG浓度（HR=0.411，95%CI为0.094～0.989，P=0.011）和淋巴结转移（HR=3.148，95%CI为1.988～5.297，P〈0.001）是患者预后不良的独立预测指标。结论 胃癌患者血清总IgG浓度下降与肿瘤进展和不良预后密切相关，说明体液免疫受损与肿瘤进展具有相关性。

Objective To investigate the relationship between total serum IgG concentration and tumor progression in patients with gastric cancer. Methods From January 2010 to May 2017, a total of 90 patients with gastric cancer in Sun Simiao Hospital of Beijing University of Chinese Medicine were enrolled as study subjects and 90 ageandsex-matched adults from normal physical examination were enrolled as control subjects. The serum IgG subgroup and total IgG concentrations were measured by enzymelinked immunosorbent assay. The relationships between serum IgG concentration in patients with gastric cancer and clinicopathologic features were analyzed. The numbers of plasma cells with CD138 antibody in both tumor and non-cancerous tissues were evaluated by immunohistochemistry. Results The total serum IgG concentration in patients with gastric cancer was significantly lower than that in healthy control group [（923.6±290.5） mg/dl vs. （1072.5±298.6） mg/dl], with a significant difference （t=3.391, P=0.001）. The total serum IgG and IgG1 concentrations were correlated with lymphatic metastasis （t=3.585, P〈0.001; t=3.545, P〈0.001） and gastric cancer stages （t=3.669, P〈0.001; t=3.401, P〈0.001）. Furthermore, the CD138＋ plasma cells in tumor tissues were significantly fewer than those in noncancerous gastric mucosa （88.7±31.9 vs. 108.5±33.4）, with significant differences （t=2.778, P=0.007）. Multivariate analysis suggested that total serum IgG concentration （HR=0.411, 95%CI： 0.0940.989, P=0.011） and lymph node metastasis （HR=3.148, 95%CI： 1.9885.297, P〈0.001） were independent predictors for poor prognosis. Conclusion Decreased total serum IgG concentration is closely related to tumor progression and poor prognosis in patients with gastric cancer, which indicates that the impaired humoral immunity is associated with tumor progression.