血红蛋白β亚基在进展期胃癌组织中的表达及对免疫治疗效果的预测价值  

Expression of hemoglobin β subunit in advanced gastric cancer tissues and its predictive value for immunotherapy efficacy

作　　者：毕建强[1] 胡秀茹[1] 孙云川[1] BI Jianqiang;HU Xiuru;SUN Yunchuan(First Department of Radiotherapy and Chemotherapy,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Hebei Province,Cangzhou 061001,China)

机构地区：[1]河北省沧州中西医结合医院放化疗一科,061001

出　　处：《国际消化病杂志》2025年第2期81-86,共6页International Journal of Digestive Diseases

摘　　要：目的观察血红蛋白β亚基(HBB)在进展期胃癌组织中的表达水平,并分析其对免疫治疗效果及患者预后的预测价值。方法选择2021年1月至2023年6月在河北省沧州中西医结合医院接受免疫治疗的88例进展期胃癌患者作为研究对象,收集治疗前患者的胃癌组织和癌旁组织(距离肿瘤组织边缘>5 cm)标本。采用实时荧光定量PCR法检测组织中HBB表达水平,并分析其与患者临床病理特征的关系。根据RECIST1.1标准评估免疫治疗效果,采用ROC曲线分析HBB对进展期胃癌患者免疫治疗效果的预测价值。采用Kaplan-Meier生存曲线分析HBB与进展期胃癌患者预后的关系。采用单因素和多因素Cox比例风险回归模型分析进展期胃癌患者预后的危险因素。结果胃癌组织中HBB mRNA相对表达量显著低于癌旁组织(P=0.000)。与HBB高表达组相比,HBB低表达组中女性、低分化、TNM分期为Ⅳ期、有淋巴结转移、有脉管侵犯的患者占比均较高(P均<0.05)。治疗有效组的胃癌组织中HBB mRNA相对表达量显著高于治疗无效组(P=0.006)。ROC曲线分析结果显示,HBB预测进展期胃癌患者免疫治疗效果的曲线下面积(AUC)、敏感度和特异度分别为0.814(95%CI:0.695~0.924)、87.56%和74.32%。HBB低表达组的中位总生存期(OS)为11.59个月,显著短于HBB高表达组(15.98个月),差异具有统计学意义(χ^(2)=54.975,P=0.000)。多因素Cox回归分析结果显示,分化程度、TNM分期、HBB均是进展期胃癌患者预后OS的独立危险因素(P均<0.05)。结论HBB在进展期胃癌组织中呈低表达,可能参与了胃癌的发生和进展,其有潜力作为预测进展期胃癌患者免疫治疗效果和预后的生物标志物。Objective This paper intends to observe the expression of hemoglobinβsubunit(HBB)in advanced gastric cancer tissues and analyze its predictive value for immunotherapy efficacy and prognosis.Methods A total of 88 patients with advanced gastric cancer who received immunotherapy in Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province from January 2021 to June 2023 were selected.Samples of gastric cancer tissue and paracancer tissue(>5 cm from the tumor tissue margin)were collected before treatment.Real-time fluorescence quantitative PCR was used to detect the expression level of HBB in tissues,and the relationship between HBB expression and clinicopathological characteristics was analyzed.Immunotherapy efficacy was evaluated according to RECIST1.1 criteria,and ROC curve was used to analyze the predictive value of HBB for immunotherapy efficacy.Kaplan-Meier survival curve was used to explore the relationship between HBB expression and prognosis,and univariate and multivariate Cox proportional risk regression models were used to analyze risk factors affecting the prognosis.Results The relative expression of HBB mRNA in gastric cancer tissues is significantly lower than that in adjacent tissues(P=0.000).In the low HBB expression group,the proportion of women,low differentiation,TNM stageⅣ,lymph node metastasis,and vascular invasion in the low HBB expression group are higher compared to the high HBB expression group(P<0.05).The relative expression of HBB mRNA in gastric cancer tissues of the effective treatment group is significantly higher than that of the ineffective treatment group(P=0.006).ROC curve analysis shows that the area under the curve(AUC),sensitivity,and specificity of HBB in predicting immunotherapy efficacy are 0.814(95%CI:0.695 to 0.924),87.56%,and 74.32%,respectively.The median overall survival(OS)of the low HBB expression group is 11.59 months,significantly lower than that in the high HBB expression group(15.98 months),with statistically significant difference(

关 键 词：进展期胃癌 血红蛋白β亚基 免疫治疗 预后 

分 类 号：R735.2[医药卫生—肿瘤]