共刺激分子B7-H3和程序性死亡因子配体1在胃肠道恶性肿瘤诊断和预后价值研究  

Diagnostic and prognostic value of costimulatory molecules b7 homolog 3 protein and programmed death ligand 1 in gastrointestinal malignancies

作　　者：茅挺[1] 韦琦 汪倩[1] 杜俏俏[3] 钟丰云[2] 张文雅[3] Mao Ting;Wei Qi;Wang Qian;Du Qiaoqiao;Zhong Fengyun;Zhang Wenya(Department of Clinical Laboratory,the Second Affiliated Hospital of Soochow University,Suzhou 215004,China;Department of Gastrointestinal Surgery,the Second Affiliated Hospital of Soochow University,Suzhou 215004,China;Health Management Center,the Second Affiliated Hospital of Soochow University,Jiangsu Suzhou 215004,China)

机构地区：[1]苏州大学附属第二医院检验科,215004 [2]苏州大学附属第二医院胃肠外科,215004 [3]苏州大学附属第二医院健康管理中心,215004

出　　处：《中华实验外科杂志》2022年第3期548-551,共4页Chinese Journal of Experimental Surgery

基　　金：苏州市科技发展计划项目(SYS2020144)。

摘　　要：目的探讨共刺激分子B7-H3和程序性死亡因子配体1(PD-L1)用于胃肠道恶性肿瘤诊断和判断转移的临床价值。方法选取2016年7月至2017年3月在苏州大学附属第二医院住院并经病理检查确诊为胃肠恶性肿瘤的患者40例(胃癌和肠癌各20例)为研究对象。采集术前和术后血清,同期收取20例健康体检者血清作为对照。采用酶联免疫吸附试验法检测血清中B7-H3、PD-L1和组织多肽特异性抗原(TPS)的表达水平;采用化学发光法检测血清中癌胚抗原(CEA)和糖类抗原(CA199)的表达水平。分析B7-H3和PD-L1手术前后的变化和肿瘤淋巴结转移的关系,组间比较采用t检验。结果胃肠道肿瘤患者术前血清中B7-H3浓度明显高于对照组[(20.1±5.5)ng/ml比(6.8±1.9)ng/ml,t=8.454,P<0.01];术前B7-H3浓度与CEA(r=0.377,P<0.05)和CA199(r=0.373,P<0.05)的含量呈正相关;术后B7-H3含量变化与CA199含量变化存在一致性(χ^(2)=5.507,P<0.05)。术后B7-H3含量维持高水平与肿瘤发生淋巴结转移显著相关(χ^(2)=8.386,P<0.01)。胃肠道肿瘤患者术前血清中PD-L1水平明显高于对照组[(275.6±36.8)pg/ml比(197.4±1.6)pg/ml,t=2.268,P<0.05],且与CEA的含量呈正相关(r=0.535,P<0.01);术后PD-L1的变化与CEA的术后变化明显相关(χ^(2)=5.199,P<0.05)。结论血清中B7-H3和PD-L1含量对胃肠道肿瘤有诊断价值;术后B7-H3的变化有助于判断肿瘤是否转移。Objective The incidence and mortality rate of gastrointestinal cancer are increasing,and its early diagnosis and prognosis lack ideal serological markers.In this paper,we evaluated the feasibility of b7 homolog 3 protein(B7-H3)and programmed death ligand 1(PD-L1)as markers of gastrointestinal malignancies.Methods A total of 40 patients(20 cases of gastric cancer and 20 cases of colorectal cancer)who were admitted to the Second Affiliated Hospital of Soochow University from July 2016 to March 2017 and confirmed by pathological examination as gastrointestinal malignancies were selected as the research subjects.The sera from 20 healthy subjects were collected as controls.The levels of PD-L1,B7-H3,tissue polypeptide specific antigen(TPS),carcinoembryonic antigen(CEA)and carbohydrate antigen 199(CA199)were measured.The changes ofB7-H3 and PD-L1 and their correlation with the tumor lymph node metastasis were statistically analyzed.Results The expression of B7-H3 in patients was significantly higher than that in the control group[(20.1±5.5)versus(6.8±1.9)ng/ml,t=8.454,P<0.05].Preoperative B7-H3 concentration was positively correlated with CEA(r=0.377,P<0.05)and CA199(r=0.373,P<0.05).The change of B7-H3 concentration was consistent with that of CA199 after operation(χ^(2)=5.507,P<0.05).The high level of B7-H3 after operation was significantly correlated with the occurrence of lymph node metastasis(χ^(2)=8.386,P<0.01).The PD-L1 level in patients with gastrointestinal tumors was significantly higher than that in the control group[(275.6±36.8)versus(197.4±1.6)pg/ml,t=2.268,P<0.05].The level of PD-L1 was positively correlated with the concentration of CEA(r=0.535,P<0.01).The change of PD-L1 concentration was consistent with that of CEA(χ^(2)=5.199,P<0.05)after operation.Conclusion The levels of B7-H3 and PD-L1 in serum have diagnostic value for gastrointestinal tumors.The change of B7-H3 after operation is helpful to judge whether the tumor is metastatic.

关 键 词：共刺激分子 程序性死亡因子配体1 胃肠道肿瘤 

分 类 号：R735[医药卫生—肿瘤]