协同刺激分子B7-H4与CD11c共表达对细胞因子诱导的杀伤细胞治疗胃癌患者预后的影响  

Effects of coexpression of B7-H4 and CD11c on prognosis of patients with gastric cancer treated by cytokine-induced killer cells

作　　者：杨璟[1] 陈建平[1] 徐斌[1] 宁忠华[1] 徐云[1] 裴红蕾[1] 吴昌平[1] 蒋敬庭[1] 

机构地区：[1]苏州大学附属第三医院肿瘤生物诊疗中心常州市医学生物技术重点实验室,常州213003

出　　处：《中华实验外科杂志》2015年第3期460-462,共3页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金资助项目（81171653、30950022、30972703）;江苏省科技型企业技术创新基金资助项目（BC2012093）;江苏省“333工程”科研项目资助项目（BRA2013054）;江苏省卫生厅医学科研招标立项课题（H201350）;常州市社会发展计划基金资助项目（CE20125017、CE20135048）

摘　　要：目的 观察协同刺激分子B7-H4及黏附分子CD11c在胃癌组织中的不同表达水平,并观察其对细胞因子诱导的杀伤细胞（CIK）治疗对胃癌患者预后的影响.方法 应用免疫组织化学法检测88例胃癌患者手术标本中B7-H4及CD11c的表达水平.采用x2检验比较CIK联合化疗组与单纯化疗组患者临床资料的均衡性.采用Kaplan-Meier法和Log-rank检验比较B7-H4、CD11c不同表达水平及CIK联合化疗、单纯化疗患者无瘤生存期及生存期的差异.采用多因素Cox模型分析B7-H4、CD11c不同表达水平联合CIK治疗与复发和死亡的关联强度.结果 CIK联合化疗组和单纯化疗组除在肿瘤转移差异有统计学意义外,其余临床资料及B7-H4、CD11c表达水平在两组间分布差异无统计学意义（P＞0.05）.CIK联合化疗＋CD11c高表达＋B7-H4低表达患者无瘤生存期及生存期明显高于单纯化疗＋ CD11c低表达＋B7-H4高表达患者（59个月比15个月、67个月比22个月,P＜0.01）.调整了性别、年龄、TNM分期、肿瘤分化程度、肿瘤大小等混杂因素后,与CIK联合化疗＋ CD11c高表达＋B7-H4低表达组比较,单纯化疗＋CD1 1c低表达＋B7-H4高表达组患者的复发率和死亡率明显升高,其风险比（HR）[95％可信区间（CI）]分别为5.06（1.64 -15.56）、6.51（2.09 -20.29）.结论 CD11c高表达、B7-H4低表达胃癌患者接受CIK联合化疗的治疗方案将可能延长无瘤生存时间及生存时间.Objective To investigate the effects of the expression level of costimulatory molecules B7-H4 and adhesion molecules CD11c combined with cytokine-induced killer cells （CIK） therapy on the prognosis of patients with gastric cancer.Methods Tissue specimens from 88 cases of gastric cancer were evaluated for the expression levels of B7-H4 and CD11c by immunohistochemistry.The balance of clinical data between CIK therapy combined with chemotherapy group and chemotherapy group was evaluated by using chi-square test.Median disease-free survival time and median survival time in patients with different expression levels of B7-H4,CD11 c and methods of treatment were compared by using Kaplan-Meier and Log-rank test.The Cox model was used to evaluate the hazard risk （HR） of the link strength between the different expression levels of B7-H4 and CD11c combined with CIK therapy and recurrence,mortality.Results There was no significant difference in clinical data and expression levels of B7-H4 and CD11c between CIK combined with chemotherapy group and single chemotherapy group except metastasis.The median disease-free time and median survival time were significant difference between CIK combined with chemotherapy group ＋ CD1 1c high ＋ B7-H4 low and chemotherapy group ＋ CD11 c low ＋ B7-H4 high （P 〈0.01）.Adjusted for sex,age,TNM stage,tumor differentiation,and tumor size,the recurrence and mortality were higher in single chemotherapy group ＋ CD1 1c low ＋ B7-H4 high as compared with CIK combined with chemotherapy group ＋ CD11 c high ＋ B7-H4 low （59 months vs.15 months,67 months vs.22months） with the HR value [95% confidence interval （CI）] being 5.06 （1.64-15.56） and 6.51（2.09-20.29） respectively.Conclusion Patients with high expression of CD11 c and low expression of B7-H4 in combination with the CIK chemotherapy may prolong disease-free survival time and survival time.

关 键 词：胃癌 B7-H4 CD11C 细胞因子诱导的杀伤细胞 

分 类 号：R735.2[医药卫生—肿瘤]