CN117054649A - Chronic atrophic gastritis transformation marker for stomach cancer and application thereof - Google Patents
Chronic atrophic gastritis transformation marker for stomach cancer and application thereof Download PDFInfo
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Abstract
The invention provides a marker for converting chronic atrophic gastritis into gastric cancer and application thereof, wherein the marker is PMN-MDSCs. The invention discovers that the expression level of PMN-MDSCs is gradually up-regulated along with the progress of gastric inflammation-cancer for the first time, and the PMN-MDSCs content is positively correlated with the OLGA classification stage of patients with chronic atrophic gastritis. Further calculation of the segmentation efficacy of PMN-MDSCs for OLGAIII/IV segmentation revealed an area under the ROC curve of 0.9333, a sensitivity of 1 and a specificity of 0.8. Therefore, the PMN-MDSCs can be used as a specific marker for converting chronic atrophic gastritis into gastric cancer, has excellent diagnosis efficacy on patients with high canceration risk of chronic atrophic gastritis, is beneficial to carrying out dangerous stratification on the patients with chronic atrophic gastritis, and screens out patients with high risk of gastric cancer, thereby realizing early diagnosis and early treatment of gastric cancer.
Description
Technical Field
The invention belongs to the technical field of molecular diagnosis, and particularly relates to a marker for converting chronic atrophic gastritis into gastric cancer and application thereof.
Background
About 41 ten thousand new stomach cancers in China every year belong to major chronic non-infectious diseases affecting national health, and reducing the incidence rate and the death rate of stomach cancers in China becomes a major public health problem to be solved urgently. Stomach cancer in China is mainly intestinal type stomach cancer, and the intestinal type stomach cancer has a relatively fixed evolution form, namely, the stomach cancer starts from chronic inflammation and develops into chronic atrophic gastritis (chronic atrophic gastritis, CAG), intestinal metaplasia and intraepithelial neoplasia, and finally reaches stomach cancer. Among them, chronic atrophic gastritis and its associated intestinal metaplasia and intraepithelial neoplasia are important precancerous diseases, and are closely related to the occurrence of gastric cancer. Therefore, the development of biomarkers capable of monitoring the conversion of chronic atrophic gastritis "inflammatory-cancer" and predicting the risk of gastric cancer is of great importance for the early diagnosis and treatment of gastric cancer.
Myeloid-lineage suppressor cells (MDSCs) are a population of cells with potent immunosuppressive effects that play a key role in creating an immunosuppressive microenvironment. MDSCs are largely expanded from the normal differentiation of myeloid cells. Under normal physiological conditions, hematopoietic stem cells differentiate into common myeloid progenitor cells, which are subdivided into Immature Myeloid Cells (IMCs), which further differentiate into mature neutrophils, macrophages or dendritic cells. When the organism is subjected to pathological conditions such as tumor, inflammation, infection, wound and the like, the normal differentiation of the IMCs can be blocked by inflammatory factors or cytokines from tumor sources, the IMCs are induced to become MDSCs, and the MDSCs are recruited, amplified and activated in peripheral blood, bone marrow or pathological parts. Whether MDSCs can recognize gastric cancer risk in patients with chronic atrophic gastritis has not been reported.
Disclosure of Invention
Based on the above, the invention aims to provide a PMN-MDSC (permanent magnet synchronous motor) as a marker for converting chronic atrophic gastritis into gastric cancer and application thereof in preparing a reagent for evaluating the risk of converting chronic atrophic gastritis into gastric cancer.
In order to achieve the above purpose, the present invention adopts the following technical scheme.
The application of human PMN-MDSC as a marker in preparing a reagent for evaluating the risk of transforming chronic atrophic gastritis into gastric cancer.
The invention also provides application of the reagent for detecting the content of the human PMN-MDSC in the biological sample in preparing a product for evaluating the risk of converting chronic atrophic gastritis into gastric cancer.
In some embodiments, the biological sample is a human peripheral blood sample.
In some embodiments, the product is a human flow cytometry detection kit.
The invention also provides application of the human PMN-MDSC as a marker in screening a reagent for evaluating the risk of transforming chronic atrophic gastritis into gastric cancer.
In some embodiments, the flow cytometry analysis of the human PMN-MDSC is labeled as
HLA-DR - CD11b + CD14 - CD15 + HLA-DR negative, CD11b positive, CD14 negative, CD15 positive.
The invention also provides a risk assessment kit for converting chronic atrophic gastritis into gastric cancer, which comprises a reagent for detecting the content of human PMN-MDSC in a biological sample.
In some embodiments, the reagent comprises the following antibodies: human HLA-DR antibodies, human CD11b antibodies, human CD14 antibodies, human CD15 antibodies.
In some embodiments, the antibodies are modified with different fluorescent groups.
In some embodiments, the kit is a human flow cytometry detection kit.
According to the invention, the first time of research discovers that the expression level of PMN-MDSCs in blood samples of patients with chronic superficial gastritis, chronic atrophic gastritis and gastric cancer is gradually up-regulated along with the progress of gastric inflammation-cancer, and the difference has statistical significance. PMN-MDSCs levels correlated positively with OLGA grading in patients with chronic atrophic gastritis (r=0.6427, p=0.0072). Further calculation of the segmentation efficacy of PMN-MDSCs for OLGAIII/IV segmentation, found an area under ROC curve of 0.9333, sensitivity of 1, specificity of 0.8, p=0.0048. Therefore, the PMN-MDSCs can be used as a specific marker for converting chronic atrophic gastritis into gastric cancer, has excellent diagnosis efficacy on patients with high canceration risk of chronic atrophic gastritis, is beneficial to carrying out dangerous stratification on the patients with chronic atrophic gastritis, and screens out patients with high risk of gastric cancer, thereby realizing early diagnosis and early treatment of gastric cancer.
Drawings
FIG. 1 shows typical flow cytometry detection analysis results.
FIG. 2 is a graph showing the results of statistical analysis of PMN-MDSCs content in biological samples from various groups of patients.
FIG. 3 is a correlation analysis of PMN-MDSCs with OLGA fractionation stage.
FIG. 4 shows the results of ROC curve analysis of PMN-MDSCs for assessing gastric cancer risk.
Detailed Description
The experimental methods of the present invention, in which specific conditions are not specified in the following examples, are generally conducted under conventional conditions or under conditions recommended by the manufacturer. The various chemicals commonly used in the examples are commercially available.
Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. The terminology used in the description of the invention herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention.
The terms "comprising" and "having" and any variations thereof, are intended to cover a non-exclusive inclusion. For example, a process, method, apparatus, article, or device that comprises a list of steps is not limited to the elements or modules listed but may alternatively include additional steps not listed or inherent to such process, method, article, or device.
In the present invention, the term "plurality" means two or more. "and/or", describes an association relationship of an association object, and indicates that there may be three relationships, for example, a and/or B, and may indicate: a exists alone, A and B exist together, and B exists alone. The character "/" generally indicates that the context-dependent object is an "or" relationship.
The international atrophy study group in 2005 proposed a grading and staging standard for gastric mucosal inflammatory response, degree and extent of atrophy (i.e., chronic gastritis OLGA grading and staging system). The system evaluates the risk of cancerous changes based on the extent and degree of gastric mucosal atrophy.
OLGA staging is as follows:
wherein, the stage (III/IV) of the high-risk OLGA is closely related to the high risk of gastric cancer, and the stage III and IV belong to patients with high risk of gastric cancer.
The following description is made with reference to specific embodiments.
Example 1
The content of PMN-MDSCs in peripheral blood samples of 15 cases of chronic superficial gastritis (CNAG), 16 cases of Chronic Atrophic Gastritis (CAG) and 7 cases of Gastric Cancer (GC) was examined by flow cytometry. All patients who were included in the test were clinically diagnosed patients, and peripheral blood of the patients was collected by anticoagulation of venous EDTA after informed consent was signed with the patients.
Mononuclear lymphocytes (PBMCs) were isolated from all peripheral blood samples using lymphocyte separation fluids (Tianjin, ocean), and the procedure was strictly followed according to the kit instructions. PBMC obtained by separation are stained as follows:
(1) Each sample is 1 x 10 6 Adding PBMC into a flow tube, adding 5ml PBS buffer solution, mixing well, centrifuging at 2000rpm/min for 5min, discarding the supernatant, and collecting cell precipitate;
(2) Adding 100 μl of a flow antibody dilution comprising human HLA-DR-APC-cy 7 antibody, human CD11 b-BUV 396 antibody, human CD 14-APC antibody, human CD 15-BV 605 body to the cell pellet according to 1:200, adding all kinds of antibodies into PBS buffer solution for dilution to obtain the streaming antibody dilution;
(3) Placing the flow tube on a vortex oscillator for uniform vibration and mixing, and then dyeing for 30min at 4 ℃ in a dark place;
(4) Adding precooled PBS buffer solution into a flow tube, centrifuging at 2000rpm/min for 5min, and discarding the supernatant; cells were resuspended in 300 μl of pre-chilled PBS buffer, then detected on-press using a flow analyzer (BD Canto II, USA), data obtained, and analyzed using FlowJo10 software.
Statistical analysis: the correlation analysis discusses the phase correlation of PMN-MDSCs and OLGA by adopting the rank sum test in IBM SPSS statistical software to carry out the group comparison, and the ROC curve detects the diagnosis efficacy of PMN-MDSCs on patients with high risk of gastric cancer. The difference was considered statistically significant with P < 0.05.
FIG. 1 shows typical flow cytometry detection analysis results. As shown in FIG. 2, the PMN-MDSCs content in peripheral blood of GC patients is significantly higher than that of CAG patients and CNAG patients; and the PMN-MDSCs content in the peripheral blood of the CAG patient is obviously higher than that of the CNAG patient. The expression level of PMN-MDSCs in blood samples of patients with chronic superficial gastritis, chronic atrophic gastritis and gastric cancer is gradually up-regulated along with the progress of gastric inflammation-cancer, and the PMN-MDSCs are suggested to be used as gastric inflammation-cancer risk assessment markers.
Further, to evaluate the efficacy of PMN-MDSCs as a marker for gastric "inflammation-cancer" risk assessment, CAG patients were classified into low risk patients (stage i and stage ii) groups (10 cases) and high risk patients (stage iii and stage iv) groups (6 cases) according to OLGA classification, and the correlation between PMN-MDSCs and OLGA classification was analyzed. As shown in fig. 3, PMN-MDSCs correlated positively with OLGA fractionation stage (r=0.6427, p=0.0072). The ROC curve analysis result shows that when PMN-MDSCs are used for evaluating the risk of gastric cancer (high risk in III phase and IV phase), the area under the curve is 0.9333, the sensitivity is 1, the specificity is 0.8, p=0.0048, and the diagnosis performance is good, so that the PMN-MDSCs can be used as a specific marker for evaluating the risk of gastric "inflammation-cancer".
In conclusion, the invention discovers that the expression level of PMN-MDSCs in blood samples of patients with chronic superficial gastritis, chronic atrophic gastritis and gastric cancer is gradually up-regulated along with the progress of gastric inflammation-cancer, is positively related to the stage of OLGA grading, can be used as a specific marker for risk assessment of gastric inflammation-cancer, and has better diagnosis performance.
The technical features of the above embodiments may be arbitrarily combined, and all possible combinations of the technical features in the above embodiments are not described for brevity of description, however, as long as there is no contradiction between the combinations of the technical features, they should be considered as the scope of the description.
The foregoing examples illustrate only a few embodiments of the invention and are described in detail herein without thereby limiting the scope of the invention. It should be noted that it will be apparent to those skilled in the art that several variations and modifications can be made without departing from the spirit of the invention, which are all within the scope of the invention. Accordingly, the scope of protection of the present invention is to be determined by the appended claims.
Claims (10)
1. The application of human PMN-MDSC as a marker in preparing a reagent for evaluating the risk of transforming chronic atrophic gastritis into gastric cancer.
2. The application of a reagent for detecting the content of human PMN-MDSC in biological samples in preparing a product for evaluating the risk of converting chronic atrophic gastritis into gastric cancer.
3. The use according to claim 2, wherein the biological sample is a human peripheral blood sample.
4. The use according to claim 2, wherein the product is a human flow cytometry detection kit.
5. The application of human PMN-MDSC as a marker in screening a reagent for evaluating the risk of transforming chronic atrophic gastritis into gastric cancer.
6. The use according to any one of claims 1 to 4, wherein the flow cytometry analysis markers of human PMN-MDSC are HLA-DR - CD11b + CD14 - CD15 + 。
7. A kit for assessing the risk of conversion of chronic atrophic gastritis to gastric cancer, wherein the kit comprises reagents for detecting the level of human PMN-MDSC in a biological sample.
8. The kit of claim 6, wherein the reagents comprise the following antibodies: human HLA-DR antibodies, human CD11b antibodies, human CD14 antibodies, human CD15 antibodies.
9. The kit of claim 7, wherein the antibodies are modified with different fluorophores.
10. The kit of any one of claims 7 to 9, wherein the kit is a human flow cytometry detection kit.
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