摘要
目的分析癌旁组织肥大细胞免疫抑制表型对抗酸药治疗史高危胃癌患者的早期诊断价值。方法选取行手术切除的101例胃癌患者的组织标本,按照是否有抗酸药治疗史分为无抗酸药治疗史组和有抗酸药治疗史组。腹腔镜手术前准备与常规开腹手术一致,首先采用气管插管进行全身麻醉,由肿瘤部位的不同行全胃切除术、远端胃大部切除术。结果免疫组化结果显示,胃癌组织和对应癌旁组织中均存在CD80、CD86以及HLA-DR表达,CD80、CD86以及HLA-DR在胃癌组织中均表达于细胞膜,CD80在胃癌组织中阳性表达率为53.47%(54/101),在癌旁组织中阳性表达率为28.71%(29/101),差异有统计学意义(χ^(2)=12.782,P<0.05);CD86在胃癌组织中阳性表达率为82.18%(83/101),在癌旁组织中阳性表达率为76.24%(77/101),差异无统计学意义(χ^(2)=1.082,P>0.05)。Western Blot法显示,无抗酸药治疗史组CD80蛋白表达水平明显高于有抗酸药治疗史组(P<0.05),CD86蛋白表达水平与有抗酸药治疗史组比较,差异无统计学意义(P>0.05)。肿瘤分级G 3级患者胃癌组织中CD80表达水平明显高于肿瘤分级G 1、G 2级患者(P<0.05),有肌层浸润和肿瘤远处转移患者胃癌组织中CD80表达明显高于无肌层浸润和肿瘤远处转移患者(P<0.05),不同性别、年龄、TNM分期、肿瘤分化患者CD80表达比较,差异无统计学意义(P>0.05),不同性别、年龄、TNM分期、肿瘤分级、肿瘤分化、肌层浸润以及肿瘤远处转移患者CD86表达比较,差异无统计学意义(P>0.05)。癌旁组织CD80检测对抗酸药治疗史高危患者胃癌早期诊断结果与病理诊断结果比较显示,CD80诊断结果的灵敏度为86%,特异度为72%,假阳性率为28%,假阴性率为14%,约登指数为0.58。癌旁组织CD86检测对抗酸药治疗史高危患者胃癌早期诊断结果与病理诊断结果比较显示,CD86诊断结果的灵敏度为82%,特异度为64%,假阳性率为36%,假阴性率为18%,约登指数为0.46。结论癌旁组织CD80和CD86检测对抗酸药治疗史高危患者胃癌早期诊断均具有较好的临床价值,而CD80比CD86筛检价值更高。癌旁组织肥大细胞免疫抑制表型检测提高抗酸药治疗史高危患者胃癌早期诊断灵敏度临床可行,有助于胃癌的早期临床筛检。
Objective To the study the early diagnostic value of mast cell immunosuppressive phenotype in paracancerous tissues in high-risk gastric cancer patients with a history of antacid therapy.Methods The tissue specimens of 101 patients with gastric cancer who underwent surgical resection were selected and divided into 2 groups according to whether they had a history of antacid treatment:the group without a history of antacid treatment and the group with a history of antacid treatment.The preparation before laparoscopic surgery was the same as that of conventional open surgery.Firstly,tracheal intubation was used for general anesthesia,and total gastrectomy and distal subtotal gastrectomy were performed according to different tumor sites.Results The results of immunohistochemistry showed that CD80,CD86 and HLA-DR were expressed in gastric cancer tissues and corresponding adjacent tissues.CD80,CD86 and HLA-DR were all expressed in the cell membrane in gastric cancer tissues.The positive expression rate of CD80 in gastric cancer tissues was 53.47%(54/101),and the positive expression rate in adjacent tissues was 28.71%(29/101),the difference was statistically significant(χ^(2)=12.782,P<0.05);the positive expression rate of CD86 in gastric cancer tissue 82.18%(83/101),the positive expression rate in adjacent tissues was 76.24%(77/101),the difference[LM]was not statistically significant(χ^(2)=1.082,P>0.05).Western Blot method showed that the expression level of CD80 protein in the group without history of antacid treatment was significantly higher than that in the group with history of antacid treatment(P<0.05).Compared with the group with history of antacid treatment,the CD86 protein expression level was not statistically different(P>0.05).The CD80 expression in gastric cancer tissue of patients with tumor grade G 3 was significantly higher than that in patients with tumor grades G 1 and G 2(P<0.05).The CD80 expression in gastric cancer tissue of patients with myometrial invasion and distant tumor metastasis was significantly higher than that in patients without myometrial invasion and with distant metastasis(P<0.05),the CD80 expression of patients in different gender,age,TNM stage,and tumor differentiation were not statistically different(P>0.05),and the difference was not statistically significant(P>0.05).Different gender,age,TNM stage,tumor grade,tumor differentiation,There was no significant difference in the expression of CD86 in patients with muscle invasion and distant metastasis(P>0.05).CD80 detection in adjacent tissues of antacids in high-risk patients with gastric cancer early diagnosis results compared with pathological diagnosis results showed that the sensitivity of CD80 diagnosis results was 86%,specificity was 72%,false positive rate was 28%,false negative rate was 14%,Yoden index was 0.58.Comparison of CD86 detection in adjacent tissues of high-risk patients with gastric cancer with a history of antacid treatment showed that the sensitivity of CD86 diagnosis was 82%,specificity was 64%,false positive rate was 36%,and false negative rate was 18%,Yoden The index is 0.46.Conclusion The detection of CD80 and CD86 in adjacent tissues has good clinical value in the early diagnosis of gastric cancer in high-risk patients with a history of antacid therapy,and CD80 has a higher screening value than CD86.Detection of immunosuppressive phenotype of mast cells in adjacent tissues improves the sensitivity of early diagnosis of gastric cancer in high-risk patients with a history of antacid therapy,which is clinically feasible and helpful for early clinical screening of gastric cancer.
作者
杜云辉
屈中玉
刘越
孙星
盛晶
董起杭
万里新
DU Yunhui;QU Zhongyu;LIU Yue(Nanyang Central Hospital,Nanyang,473001)
出处
《实用癌症杂志》
2024年第9期1410-1414,共5页
The Practical Journal of Cancer
基金
北京科创医学发展基金会项目(编号:232102310045)。
关键词
癌旁组织
肥大细胞免疫抑制表型
抗酸药
胃癌
早期诊断
Adjacent tissues
Mast cell immunosuppressive phenotype
Antacids
Gastric cancer
Early diagnosis
