CN105021828B - By detecting that three phase colorectal carcinoma patients serums predict tumor patient prognosis - Google Patents
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Abstract
本发明涉及RNATES、MIP‑1b、IFN‑g的新用途,可通过检测三期结直肠肿瘤患者血清中RNATES、MIP‑1b、IFN‑g水平预测肿瘤患者预后。其优点表现在:本发明第一次证明通过检测患者血清中RNATES、MIP‑1b、IFN‑g的水平可以预测三期结直肠癌患者的预后状态。
The present invention relates to a new application of RNATES, MIP-1b, and IFN-g, which can predict the prognosis of tumor patients by detecting the levels of RNATES, MIP-1b, and IFN-g in serum of patients with colorectal tumors of three stages. Its advantages are as follows: the present invention proves for the first time that the prognosis status of stage III colorectal cancer patients can be predicted by detecting the levels of RNATES, MIP‑1b and IFN‑g in the patient's serum.
Description
技术领域technical field
本发明涉及结直肠癌技术领域,具体地说,是通过检测三期结直肠肿瘤患者血清中RNATES、MIP-1b、IFN-g水平预测肿瘤患者预后。The invention relates to the technical field of colorectal cancer, specifically, predicting the prognosis of tumor patients by detecting the levels of RNATES, MIP-1b and IFN-g in the serum of patients with three-stage colorectal tumors.
背景技术Background technique
结直肠肿瘤是常见的恶性肿瘤之一,发病率在男女中都很高,在全球肿瘤死亡病例中位居第四位。目前,三期肠癌患者是指初次诊断时患者即有淋巴结的转移,对于三期肠癌病人,手术切除和辅助放化疗是标准的治疗方案,然而仍然有四分之一的三期肠癌患者接受了标准的治疗之后,仍然出现了复发和远处转移的情况。Colorectal tumor is one of the common malignant tumors, with a high incidence rate in both men and women, and it ranks fourth in the global cancer death cases. At present, patients with stage III bowel cancer refer to patients with lymph node metastasis when they are first diagnosed. For patients with stage III bowel cancer, surgical resection and adjuvant radiotherapy and chemotherapy are the standard treatment options. However, there are still a quarter of patients with stage III bowel cancer After the patient received standard treatment, recurrence and distant metastasis still occurred.
影响肠癌患者预后的因素有很多,很多研究表明免疫系统失衡可以影响患者的预后。最近,很多研究表明,免疫因子在调节肿瘤患者的化疗敏感性上起到了重要作用。趋化因子是一类小分子多肽,肿瘤微环境中的趋化因子一般是肿瘤细胞自身分泌的或者是被招募而来,越来越多的证据表明,肿瘤微环境中趋化因子的聚集跟抗肿瘤的免疫反应相关。肿瘤细胞的增值、侵袭和转移都受到趋化因子的调节。趋化因子可以在患者的外周血中检测到,因此,检测患者外周血中趋化因子的浓度是潜在预测肿瘤患者预后的手段。There are many factors that affect the prognosis of bowel cancer patients, and many studies have shown that immune system imbalance can affect the prognosis of patients. Recently, many studies have shown that immune factors play an important role in regulating the chemosensitivity of tumor patients. Chemokines are a class of small molecular polypeptides. Chemokines in the tumor microenvironment are generally secreted or recruited by tumor cells. More and more evidence shows that the accumulation of chemokines in the tumor microenvironment is closely related to Anti-tumor immune response. The proliferation, invasion and metastasis of tumor cells are regulated by chemokines. Chemokines can be detected in the peripheral blood of patients. Therefore, detecting the concentration of chemokines in peripheral blood of patients is a potential means of predicting the prognosis of cancer patients.
目前,已经有研究表明IL-6(白细胞趋化因子6)、IL-10和VEGF(血管生长因子)的血清水平是反应结直肠肿瘤患者预后的一个重要指标,我们团队前期的工作也发现IL-22的在患者血清和肿瘤组织中的水平都与结直肠肿瘤患者的化疗抵抗以及总体生存率相关。At present, studies have shown that the serum levels of IL-6 (leukocyte chemoattractant 6), IL-10 and VEGF (vascular growth factor) are an important indicator of the prognosis of patients with colorectal tumors. Our team's previous work also found that IL-10 The levels of -22 in patient serum and tumor tissue are correlated with chemotherapy resistance and overall survival in patients with colorectal tumors.
然而,以前的研究都是基于一个或者很少几个因子的检测,本次试验运用更加先进的高通量Luminex200技术,这个技术一次试验可以同时检测40多个细胞因子的表达水平,与传统的酶联免疫吸附试验(ELISA)相比,这种技术需要的临床样本更少,结果更加精确可信。虽然,已经有人用这个方法在病人血清中进行过试验,也得出一些跟预后相关的细胞因子,但是,专门针对三期结直肠癌病人的试验,目前没有人进行研究,我们是第一家。However, the previous studies were all based on the detection of one or a few factors. This test uses the more advanced high-throughput Luminex200 technology. This technology can detect the expression levels of more than 40 cytokines at the same time in one test, which is different from the traditional one. Compared with enzyme-linked immunosorbent assay (ELISA), this technique requires fewer clinical samples, and the results are more accurate and reliable. Although some people have used this method to test in patient serum, and some cytokines related to prognosis have been obtained, but no one has conducted research on patients with stage III colorectal cancer. We are the first .
发明内容Contents of the invention
本发明的目的是针对现有技术中的不足,提供RNATES、MIP-1b、IFN-g的新用途。The purpose of the present invention is to provide new uses of RNATES, MIP-1b and IFN-g aiming at the deficiencies in the prior art.
本发明的再一的目的是,提供一种筛选预测三期结直肠肿瘤患者预后的细胞因子的方法。Another object of the present invention is to provide a method for screening cytokines that predict the prognosis of patients with stage III colorectal tumors.
本发明的另一的目的是,提供一种治疗三期结直肠肿瘤的药物。Another object of the present invention is to provide a drug for treating three-stage colorectal tumors.
为实现上述目的,本发明采取的技术方案是:RNATES、MIP-1b、IFN-g在制备预测三期结直肠肿瘤患者预后的试剂中的应用。In order to achieve the above object, the technical scheme adopted by the present invention is: the application of RNATES, MIP-1b, and IFN-g in the preparation of reagents for predicting the prognosis of patients with colorectal tumors in the third stage.
所述的试剂检测三期结直肠肿瘤患者血清中RNATES、MIP-1b或IFN-g的水平。The reagent detects the levels of RNATES, MIP-1b or IFN-g in serum of patients with three-stage colorectal tumors.
一种预测三期结直肠肿瘤患者预后的试剂盒,所述的试剂盒检测三期结直肠肿瘤患者血清中RNATES、MIP-1b或IFN-g的水平。A kit for predicting the prognosis of patients with stage III colorectal tumors. The kit detects the levels of RNATES, MIP-1b or IFN-g in serum of patients with stage III colorectal tumors.
一种检测方法,所述的方法检测三期结直肠肿瘤患者血清中RNATES、MIP-1b或IFN-g的水平。A detection method, the method detects the levels of RNATES, MIP-1b or IFN-g in the serum of patients with stage III colorectal tumors.
一种预测三期结直肠肿瘤患者预后评分的方法,所述的方法检测三期结直肠肿瘤患者血清中RNATES、MIP-1b或IFN-g的水平,并根据RNATES、MIP-1b或IFN-g的水平进行评分。A method for predicting the prognosis score of patients with three-stage colorectal tumors, the method detects the levels of RNATES, MIP-1b or IFN-g in serum of patients with three-stage colorectal tumors, and according to RNATES, MIP-1b or IFN-g level is scored.
为实现上述第二个目的,本发明采取的技术方案是:一种筛选预测三期结直肠肿瘤患者预后的细胞因子的方法,所述的方法检测病人血液中细胞因子的浓度情况,根据最小P值法确定每个细胞因子的cutoff值,然后根据cutoff值将病人分为高表达组和低表达组,接着运用Graphpad作图软件分析两组之间的生存差异,从而判断不同细胞因子对患者预后的影响。In order to achieve the above-mentioned second purpose, the technical solution adopted by the present invention is: a method for screening cytokines for predicting the prognosis of patients with stage III colorectal tumors, the method detects the concentration of cytokines in the patient's blood, and according to the minimum P The cutoff value of each cytokine was determined by the cutoff value method, and then the patients were divided into high expression group and low expression group according to the cutoff value, and then the survival difference between the two groups was analyzed by using Graphpad mapping software, so as to judge the effect of different cytokines on the prognosis of patients Impact.
所述的方法使用45因子Luminex200试剂盒检测病人血液中45个细胞因子的浓度情况。Said method uses 45 factors Luminex200 kit to detect the concentration of 45 cytokines in the patient's blood.
为实现上述第三个目的,本发明采取的技术方案是:治疗结直肠肿瘤的药物,所述的药物能够提高结直肠肿瘤患者血清中RNATES、MIP-1b水平或降低结直肠肿瘤患者血清中IFN-g水平。In order to achieve the above-mentioned third purpose, the technical solution adopted by the present invention is: a drug for treating colorectal tumors, which can increase the levels of RNATES and MIP-1b in the serum of patients with colorectal tumors or reduce the level of IFN in the serum of patients with colorectal tumors -g levels.
本发明优点在于:The present invention has the advantage that:
本发明第一次证明通过检测患者血清中RNATES、MIP-1b、IFN-g的水平可以预测三期结直肠癌患者的预后状态。The present invention proves for the first time that the prognosis status of stage III colorectal cancer patients can be predicted by detecting the levels of RNATES, MIP-1b and IFN-g in the patient's serum.
附图说明Description of drawings
附图1是MIP-1b多因素cox回归分析的结果。Accompanying drawing 1 is the result of the multivariate cox regression analysis of MIP-1b.
附图2是IFN-g多因素cox回归分析的结果。Accompanying drawing 2 is the result of IFN-g multivariate cox regression analysis.
附图3是RNATES多因素cox回归分析的结果。Figure 3 is the result of RNATES multivariate cox regression analysis.
具体实施方式detailed description
下面结合附图对本发明提供的具体实施方式作详细说明。The specific embodiments provided by the present invention will be described in detail below in conjunction with the accompanying drawings.
实施例1Example 1
试验方法experiment method
病人:patient:
连续收集了从2010年到2012年间在新华医院结直肠肛门疾病外科进行手术治疗的357例三期肠癌病人的血清,在这357例病人中其中323例病人有完整的2年DFS随访资料。From 2010 to 2012, the serum of 357 patients with stage III colorectal cancer undergoing surgical treatment in the Department of Colorectal and Anal Diseases Surgery of Xinhua Hospital was continuously collected. Among these 357 patients, 323 patients had complete 2-year DFS follow-up data.
方法method
应用Ebioscience公司的45因子Luminex200试剂盒,检测病人血液中45个细胞因子的浓度情况,根据ROC曲线确定每个细胞因子的cutoff值,然后根据cutoff值将病人分为高表达组和低表达组,接着运用graphpad作图软件分析两组之间的生存差异,从而判断不同细胞因子对患者预后的影响。The 45-factor Luminex200 kit from Ebioscience was used to detect the concentration of 45 cytokines in the patient's blood, and the cutoff value of each cytokine was determined according to the ROC curve, and then the patients were divided into high-expression group and low-expression group according to the cutoff value. Then, the graphpad software was used to analyze the survival difference between the two groups, so as to judge the influence of different cytokines on the prognosis of patients.
结果:result:
运用单因素cox回归分析发现IFN-r、IL-8、IL-10、VEGFA、MIP-1a、MIP-1b、RNATES、LIF、EOTAXIN、IP10、PIGF、NGF、HGF、VEGFD、CA199、TNFa、GMCSF 17个细胞因子是影响结直肠癌患者预后的独立危险因素(表1),然后运用多因素cox回归分析发现RNATES、MIP-1b、IFN-g仍然是影响患者预后的因素,与患者的DFS密切相关(图1,2,3)。Using single factor cox regression analysis, it was found that IFN-r, IL-8, IL-10, VEGFA, MIP-1a, MIP-1b, RNATES, LIF, EOTAXIN, IP10, PIGF, NGF, HGF, VEGFD, CA199, TNFa, GMCSF Seventeen cytokines are independent risk factors affecting the prognosis of patients with colorectal cancer (Table 1), and then using multivariate cox regression analysis, it is found that RNATES, MIP-1b, and IFN-g are still factors affecting the prognosis of patients, which are closely related to the DFS of patients. Correlation (Figures 1, 2, 3).
结论:in conclusion:
本项发明第一次证明通过检测患者血清中RNATES、MIP-1b、IFN-g的水平可以预测三期结直肠癌患者的预后状态。This invention proves for the first time that the prognosis status of stage III colorectal cancer patients can be predicted by detecting the levels of RNATES, MIP-1b and IFN-g in the patient's serum.
表1Table 1
实施例2Example 2
检测患者血清中RNATES、MIP-1b或IFN-g的水平预测三期结直肠癌患者的预后状态的试剂、试剂盒或检测方法等。A reagent, kit or detection method, etc. for detecting the levels of RNATES, MIP-1b or IFN-g in the patient's serum to predict the prognosis of patients with stage III colorectal cancer.
特别地,所述的试剂、试剂盒或检测方法同时检测RNATES、MIP-1b和IFN-g的水平。In particular, the reagent, kit or detection method simultaneously detects the levels of RNATES, MIP-1b and IFN-g.
实施例3Example 3
能够提高结直肠肿瘤患者血清中RNATES、MIP-1b水平或降低结直肠肿瘤患者血清中IFN-g水平的药物或许能够提高三期结直肠肿瘤患者的生存率,甚至治疗结直肠肿瘤。Drugs that can increase the serum levels of RNATES and MIP-1b in patients with colorectal tumors or reduce the levels of IFN-g in the serum of patients with colorectal tumors may be able to improve the survival rate of patients with stage III colorectal tumors, and even treat colorectal tumors.
以上所述仅是本发明的优选实施方式,应当指出,对于本技术领域的普通技术人员,在不脱离本发明方法的前提下,还可以做出若干改进和补充,这些改进和补充也应视为本发明的保护范围。The above is only a preferred embodiment of the present invention, it should be pointed out that for those of ordinary skill in the art, without departing from the method of the present invention, some improvements and supplements can also be made, and these improvements and supplements should also be considered Be the protection scope of the present invention.
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