原发性胃癌合并轻型地中海贫血患者外周血干扰素γ、铁调素25水平变化及临床意义

The expression and clinical significance of peripheral blood interferon-gamma and hepcidin-25 in patients with primary gastric cancer combined with thalassemia minor

目的探讨原发性胃癌合并轻型地中海贫血(简称地贫)患者外周血干扰素γ(IFN-γ)、铁调素25(Hepc-25)水平变化及临床意义。方法选择江苏省省级机关医院2017年1月至2019年12月收治的150例原发性胃癌合并轻型地贫患者(研究组)和同期收治的150例未合并轻型地贫的原发性胃癌患者(对照组),应用酶联免疫吸附法测定两组外周血IFN-γ、Hepc-25水平,应用受试者工作特征(ROC)曲线评估外周血IFN-γ、Hepc-25对原发性胃癌合并轻型地贫诊断的灵敏度与特异度。通过氰化高铁血红蛋白法测定血红蛋白(Hb)水平,IFN-γ、Hepc-25与Hb水平的关系采用Pearson相关分析。结果研究组外周血IFN-γ、Hb水平低于对照组[(115.18±27.05)ng/L比(137.17±35.66)ng/L、(88.44±10.71)g/L比(120.60±29.46)g/L],Hepc-25水平高于对照组[(49.32±15.05)μg/L比(32.66±12.22)μg/L],差异均有统计学意义(P<0.05)。研究组中α地贫、β地贫患者外周血IFN-γ、Hepc-25、Hb水平比较差异无统计学意义(P>0.05)。ROC曲线分析结果显示,曲线下面积(AUC)为0.709,截断值≤138.89 ng/L时,血清IFN-γ诊断原发性胃癌合并轻型地贫的灵敏度、特异度为81.33%、70.67%;血清Hepc-25 AUC为0.811,截断值≥40.13μg/L时,其诊断灵敏度为75.33%,特异度为74.00%。Pearson相关分析结果表明,原发性胃癌合并地贫患者外周血IFN-γ水平与Hb水平呈正相关(r=0.245,P<0.05),Hepc-25水平与IFN-γ水平呈负相关(r=-0.378,P<0.05);Hepc-25水平与Hb水平呈负相关(r=-0.647,P<0.05)。结论原发性胃癌合并轻型地贫患者外周血IFN-γ低表达,Hepc-25高表达,IFN-γ、Hepc-25水平检测对地贫诊断有一定的临床价值。

Objective To explore the expression and detection significance of peripheral blood interferon-gamma(IFN-γ)and hepcidin-25(Hepc-25)in primary gastric cancer combined with thalassemia minor.Methods One hundred and fifty primary gastric cancer combined with thalassemia minor patients admitted to of Jiangsu Province Official Hospital from January 2017 to December 2019 were selected as the research group,and 150 cases of primary gastric cancer without thalassemia minor admitted in the same period were selected as the control group.The levels of peripheral blood IFN-γand Hepc-25 in the two groups were determined by enzyme-linked immunosorbent assay,and the receiver operating characteristic curve(ROC)was used to evaluate the diagnostic sensitivity and specificity of peripheral blood IFN-γand Hepc-25 on primary gastric cancer combined with thalassemia minor.The level of hemoglobin(Hb)was measured by the cyanmethemoglobin method,and the Pearson correlation analysis was used to analyzed the relationship among the peripheral blood IFN-γ,Hepc-25 and Hb levels in the research group.Results The levels of peripheral blood IFN-γand Hb in the research group were lower than those in the control group:(115.18±27.05)ng/L vs.(137.17±35.66)ng/L,(88.44±10.71)g/L vs.(120.60±29.46)g/L;the level of Hepc-25 in the research group was higher than that in the control group:(49.32±15.05)μg/L vs.(32.66±12.22)μg/L,and the differences were statistically significant(P<0.05).There were no significant differences in the levels of peripheral blood IFN-γ,Hepc-25 and Hb between the patients withα-thalassemia andβ-thalassemia(P>0.05).The area under the curve(AUC)of thalassemia predicted by of peripheral blood IFN-γlevel was 0.709.When the cut-off value was≤138.89 ng/L,its diagnostic sensitivity and specificity were 81.33%and 70.67%respectively,and when the serum AUC of Hepc-25 was 0.811 and cut-off value was≥40.13μg/L,its diagnostic sensitivity and specificity were 75.33%and 74.00%respectively.Pearson correlation analysis showed that in the research group IFN-γand Hb had positive correlation(r=0.245,P<0.05),Hepc-25 and IFN-γhad negative correlation(r=-0.378,P<0.05);Hepc-25 and Hb had negative correlation(r=-0.647,P<0.05).Conclusions The low level of IFN-γand the high level of Hepc-25 in peripheral blood of patients with primary gastric cancer combined with thalassemia minor are related to Hb and have certain diagnostic value for thalassemia.