摘要目的:观察吲哚胺2，3-双加氧酶1(IDO1)在脑胶质瘤中的表达，探讨其表达与患者临床病例特征及生存预后的关系。方法:选取2008年2月至2011年10月的162例包括年龄、性别、病理分级等具有完整的临床及病理资料的脑胶质瘤患者的组织芯片，采用免疫组织化学方法检测组织标本中IDO1的表达水平，采用 χ2检验和Fisher精确概率法分析IDO1的表达与脑胶质瘤癌患者临床参数之间的相关性。采用Cox比例风险回归模型分析脑胶质瘤患者预后的危险因素，生存分析采用Kaplan-Meier法，计量资料采用Person χ2检验分析。 结果:162例脑胶质瘤患者组织标本中，IDO1阴性表达为74例[45.68%(74/162)]，阳性表达为88例[54.32%(88/162)]。IDO1阳性表达与病理分级[50.00%(44/88)， χ2＝3.786， P<0.05]和肿瘤复发情况[70.45%(62/88)， χ2＝24.988， P<0.05]存在相关性。单因素Cox回归分析发现影响患者预后因素有年龄、病理分级、表皮生长因子受体(EGFR)、程序性死亡因子配体1(PD-L1)和IDO1，差异有统计学意义[风险比( HR)＝0.438、0.551、4.181、2.015、3.614；95%可信区间( CI)＝0.258～0.744、0.314～0.966、1.890～9.249、1.015～4.000、1.938～6.740， P<0.05]。多因素Cox回归分析发现年龄、EGFR和IDO1( HR＝0.770、4.181、4.425，95% CI＝0.267～2.227、1.890～9.249、2.330～8.405， P<0.01)是脑胶质瘤患者预后不良的独立危险因素。Kaplan-Meier生存分析结果显示IDO1的阳性表达与患者的生存率显著降低之间呈显著相关( χ2＝18.777， P<0.05)，是患者预后不良的重要指标。 结论:IDO1在脑胶质瘤组织中阳性表达可提示患者预后差。

abstractsObjective:To investigate the expression of indoleamine 2, 3-dioxygenase 1 (IDO1) in brain glioma and its relationship with clinicopathological characteristics and survival prognosis of patients.Methods:Tissue microarrays from 162 glioma patients with complete clinical and pathological data, including age, gender, pathological grade, and other relevant parameters, were selected from February 2008 to October 2011. The expression level of IDO1 in tissue samples was detected using immunohistochemistry. The chi-square test and Fisher’s exact test were employed to analyze the correlation between IDO1 expression and clinical parameters of glioma patients. Cox proportional hazards regression model was used to identify prognostic risk factors, and survival analysis was performed using the Kaplan-Meier method. Measurement data were analyzed by Pearson’s chi-square test.Results:Among the 162 glioma tissue specimens, 74 cases [45.68% (74/162)] exhibited negative IDO1 expression, while 88 cases [54.32% (88/162)] showed positive expression. Positive IDO1 expression was significantly correlated with pathological grade [50.00% (44/88), χ2=3.786, P<0.05] and tumor recurrence [70.45% (62/88), χ2=24.988, P<0.05]. Univariate Cox regression analysis showed that the prognostic factors of patients were age, pathological grade, epidermal growth factor receptor (EGFR), programmed death ligand 1 (PD-L1) and IDO1, and the differences were statistically significant [hazard ratio ( HR)=0.438, 0.551, 4.181, 2.015, 3.614; 95% confidence interval ( CI)=0.258-0.744, 0.314-0.966, 1.890-9.249, 1.015-4.000, 1.938-6.740, P<0.05]. Multivariate Cox regression analysis showed that age, EGFR and IDO1 ( HR=0.770, 4.181, 4.425, 95% CI=0.267-2.227, 1.890-9.249, 2.330-8.405, P<0.01) were independent risk factors for poor prognosis in patients with glioma. Kaplan-Meier survival analysis showed a statistically significant correlation between IDO1 positive expression and the survival rate of patients ( χ2=18.777, P<0.05), indicating that IDO1 is an important indicator of poor prognosis. Conclusion:Positive expression of IDO1 in brain glioma tissue may indicate poor prognosis.