胃癌患者外周血吲哚胺2,3-双加氧酶mRNA的表达及其临床意义

Expression of indoleamine 2,3-dioxygenase mRNA in peripheral blood of patients with gastric cancer and its clinical significance

目的检测胃癌患者免疫逃避通路中的吲哚胺2,3-双加氧酶mRNA的表达情况,探索早期诊断胃癌患者产生免疫逃避的方法,为免疫治疗设计和创新提供可行性思路。方法收集2018年1月至2019年12月在我院住院确诊为胃癌的30例患者及20例健康体检者进行队列研究,运用RT-PCR法检测研究对象外周血中吲哚胺2,3-双加氧酶mRNA的表达水平。比较胃癌患者与健康体检者及不同时期胃癌患者的吲哚胺2,3-双加氧酶mRNA的表达差异,分析吲哚胺2,3-双加氧酶mRNA的表达与胃癌发生的相关性。结果胃癌患者外周血吲哚胺2,3-双加氧酶mRNA表达的阳性率为73.3%,显著高于健康体检者的15.0%(P<0.05)。早期胃癌患者吲哚胺2,3-双加氧酶mRNA表达的阳性率为90.5%,显著高于中期的40.0%、晚期的25.0%(P<0.05)。吲哚胺2,3-双加氧酶mRNA的表达与胃癌的发生呈线性相关[r=-0.572(95%CI:-0.733,-0.349),P<0.0001]。结论吲哚胺2,3-双加氧酶mRNA异常升高对胃癌的早期诊断可能有一定帮助,值得临床参考。

Objective To detect the expression of indoleamine 2,3-dioxygenase mRNA in the immune escape pathway of patients with gastric cancer,and to explore the methods for early diagnosis of immune escape in patients with gastric cancer,so as to provide feasible ideas for the design and innovation of immunotherapy.Methods From January 2018 to December 2019,30 patients with gastric cancer hospitalized in our hospital and 20 healthy physical examiners were collected for the cohort study,the expression level of indoleamine 2,3-dioxygenase mRNA in peripheral blood of these study objects were detected by RT-PCR method.The expression differences of indoleamine 2,3-dioxygenase mRNA in patients with gastric cancer and healthy people,and patients with gastric cancer at different stages were compared,and the correlation between the expression of indoleamine 2,3-dioxygenase mRNA and the occurrence of gastric cancer was analyzed.Results The positive rate of indoleamine 2,3-dioxygenase mRNA expression in peripheral blood of patients with gastric cancer was 73.3%,which was significantly higher than 15.0% of the healthy people(P<0.05).The positive rate of indoleamine 2,3-dioxygenase mRNA expression in patients with early gastric cancer was 90.5%,which was significantly higher than 40.0% in the middle stage and 25.0% in the advanced stage(P<0.05).There was a linear correlation between indoleamine 2,3-dioxygenase mRNA expression and the occurrence of gastric cancer[r=-0.572(95%CI:-0.733,-0.349),P<0.0001].Conclusion The abnormal increase of indoleamine 2,3-dioxygenase mRNA may be helpful for the early diagnosis of gastric cancer,which is worthy of clinical reference.