B和T淋巴细胞衰减因子在三阴性乳腺癌预后中的价值  

Prognostic value of B and T lymphocyte attenuator in triple-negative breast cancer

作　　者：朱小存 甄林林[1] 李智 宋玮[1] 万江洋 赵瑞鹏 ZHU Xiaocun;ZHEN Linlin;LI Zhi;SONG Wei;WAN Jiangyang;ZHAO Ruipeng(Department of Thyroid and Breast Surgery,The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University,Huaian 223000,China)

机构地区：[1]南京医科大学附属淮安第一医院甲乳外科,江苏淮安223000 [2]淮安市淮安医院甲乳外科,223200

出　　处：《临床肿瘤学杂志》2024年第12期1194-1199,共6页Chinese Clinical Oncology

基　　金：国家自然科学基金项目(82403191)。

摘　　要：目的 分析在三阴性乳腺癌(TNBC)中,B和T淋巴细胞衰减因子(BTLA)的生物学功能及其预后预测的应用价值。方法 检测BTLA在140对TNBC癌及癌旁组织中的表达;Kaplan-Meier plotter分析不同BTLA表达患者的预后;Cox回归分析临床病理特征及BTLA表达情况对TNBC患者预后的影响。根据Cox回归结果,用R语言建立列线图预测模型并进行评估。结果 TNBC患者癌旁组织的BTLA表达显著高于癌组织(P<0.01);140例中BTLA阳性表达69例,阴性表达71例,且BTLA阳性组患者的血清高水平糖类抗原50、肿瘤分级高、晚期pT分期及pN分期比例均低于BTLA阴性组(P<0.05)。Kaplan-Meier plotter分析显示,BTLA高表达的TNBC患者显示较好的预后(P<0.05);多因素Cox回归分析显示,BTLA阴性表达的TNBC患者有较差的无病生存期(P<0.05)。根据Cox多元分析中显著参数建立的列线图模型,该模型C指数为0.763(95%CI:0.724~0.829)。结论 在TNBC患者中,BTLA表达水平较癌旁组织低;BTLA表达情况为预测TNBC患者无病生存的独立因素;本研究建立的列线图,有较好的临床应用及预测价值。Objective To analyze the biological function of B and T lymphocyte attenuator(BTLA)and their prognostic prediction in triple-negative breast cancer(TNBC)patients.Methods One hundred and forty female patients with TNBC who underwent surgery were selected.The expression of BTLA protein and mRNA in cancer and adjacent tissues of TNBC patients were detected.The prognosis of patients with different BTLA expression was analyzed in Kaplan-Meier plotter database.Cox regression was used to analyze the influence of clinicopathological characteristics and BTLA expression on the prognosis of TNBC patients.According to the Cox regression results,a nomogram prediction model was made with R language and evaluated.Results The expression level of BTLA in adjacent tissues was higher than that in cancer tissues(P<0.01).There were 69 patients with positive expression and 71 patients with negative expression of BTLA,and the proportions of high serum carbohydrate antigen 50,high tumor grade,advanced pT stage and pN stage in the BTLA-positive group were lower than those in the BTLA-negative group(P<0.05).Analysis conducted on the Kaplan-Meier plotter database showed that TNBC patients with high BTLA expression had a better prognosis(P<0.05).Multivariate Cox regression analysis showed that TNBC patients with higher pathological grade,advanced pT and pN stages,and negative BTLA expression had poorer prognosis(P<0.05).According to the nomogram model established by significant parameters in the Cox multivariate analysis,the model C index was 0.763(95%CI:0.724-0.829).Conclusion The expression level of BTLA is lower in cancer tissues compared to adjacent tissues in TNBC patients.BTLA expression is an independent factor for predicting disease-free survival in TNBC patients.The nomogram established in this study has good clinical application and predictive value.

关 键 词：三阴性乳腺癌 B和T淋巴细胞衰减因子 生存预后 COX回归分析 列线图 

分 类 号：R737.9[医药卫生—肿瘤]